Relationship between tonsils and IgA nephropathy as well as indications of tonsillectomy

Xie, Yan; Chen, Xiangmei; Nishi, Shinichi; Narita, Ichiei; Gejyo, Fumitake

doi:10.1111/j.1523-1755.2004.00486.x

Cited by 108 publications

(77 citation statements)

References 56 publications

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“…Differences in gene expression in the tonsils between patients with IgA nephropathy and controls has been reported, 22 as have structural differences. 23 These changes may be because of continuous immune stimulation from smoking. According to this theory, the association between CKD and smoking should be observed only in IgA nephropathy patients, not in patients with other kidney diseases.…”

Section: Smoking and Ckd In Patients With Primary Glomerulonephritismentioning

confidence: 99%

Cigarette smoking and chronic kidney diseases

et al. 2011

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Observational studies have suggested that different chronic kidney diseases (CKDs) have differing relationships to smoking, but no randomized controlled trial has been conducted to examine this topic. In this article, we review available evidence concerning the relationship between smoking and each type of CKD in the general population as well as in patients with diabetes mellitus (DM), hypertension (HT), primary glomerulonephritis and kidney transplants. There is good evidence of a relationship between smoking and CKD in patients with IgA nephropathy and kidney transplant recipients, but not in patients with DM or HT. Interestingly, it has been reported that the effect of smoking on CKD progression varies depending on the CKD stage. This variation might indicate a cumulative effect of smoking, possibly through oxidative stress. A better understanding of the relationship between smoking and CKD would be useful for nephrologists.

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Section: Smoking and Ckd In Patients With Primary Glomerulonephritismentioning

confidence: 99%

Cigarette smoking and chronic kidney diseases

et al. 2011

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“…4 Among these lymphoid tissues, tonsil is the largest mucosal immune organ in the human body. 5 Tonsils consist of palatine tonsil, tubal tonsil, adenoid tonsil, and lingual tonsil, which jointly form a structure called Waldeyer's tonsillar ring, 6 the portal of the aerodigestive tract. According to some previous studies, tonsillectomy, combined with steroid pulse therapy, could significantly improve the urine test results and stabilize the renal function of IgA nephropathy patients during a long-term period.…”

Section: Introductionmentioning

confidence: 99%

“…According to some previous studies, tonsillectomy, combined with steroid pulse therapy, could significantly improve the urine test results and stabilize the renal function of IgA nephropathy patients during a long-term period. 5,7 In addition, in 1-year observation, tonsillectomy plus steroid pulse therapy could reduce the frequency of relapse based on the investigation of Ohya et al 8 However, this was a retrospective cohort study. Herein, we report the first randomized controlled clinical study that provided strong evidence for prolonged remission and fewer relapses frequency among tonsillectomized IgAN patients.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of tonsillectomy on clinical remission and relapse in patients with IgA nephropathy: a randomized controlled trial

Yang

Peng

et al. 2016

Renal Failure

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Background The efficacy of tonsillectomy in immunoglobulin A nephropathy (IgAN) remains controversial. The aim of the study was to conduct a randomized controlled trial to evaluate the effect of tonsillectomy in patients with IgAN. Methods We randomly selected 98 patients with biopsy-proven IgA nephropathy and randomly allocated to receive tonsillectomy combined with drug therapy (Group A) or drug therapy alone (Group B). The participating patients were entered into a 4-year single-center study. Remission and relapse rate were calculated for hematuria and proteinuria using the Kaplan-Meier method. Results No differences were found between the two groups in their baseline clinical and histological characteristics. Patients with tonsillectomy exhibited considerable improvement in the following aspects compared to those patients who did not undergo tonsillectomy: time to reach first remission (3.1 vs. 24.9 months, p50.001) for hematuria and (2.5 vs. 26.1 months, p50.001) for proteinuria, cumulative remission rate (91.8% vs. 46.9%, p50.001 by log-rank test) for hematuria and (95.9% vs. 51.0%, p50.001) for proteinuria, the duration of first remission (26.5 vs. 11.8 months, p ¼ 0.0047) for hematuria and (23.5 vs. 10.5 months, p ¼ 0.0012) for proteinuria, as well as lower relapse rate for hematuria and proteinuria in Group A. Conclusion Our clinical data demonstrated that tonsillectomy could be beneficial for IgAN patients, particularly by contributing to faster and longer remission, as well as reducing the frequency of possible future relapses.

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“…In cases where tonsillitis is the precipitating factor for episodic hematuria, tonsillectomy has been claimed to reduce the frequency of those episodes. However, it does not reduce the incidence of progressive renal failure [11]. As the drug therapeutics, immunosuppressive drugs (steroid, cyclophosphamide, mycophenolic acid, cyclosporine, mizoribine, etc.…”

Section: Introductionmentioning

confidence: 99%

Enhanced intrarenal oxidative stress and angiotensinogen in IgA nephropathy patients

Kobori

Katsurada

Ozawa

et al. 2007

Biochemical and Biophysical Research Communications

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This study was performed to determine whether immunoreactivity of intrarenal hemeoxygenase-1 and angiotensinogen are increased in IgA nephropathy (IgAN) patients. Hemeoxygenase-1 and angiotensinogen immunoreactivity were determined by immunohistochemistry robot system in renal specimens from 39 patients with IgAN. Normal portions of surgically resected kidney served as controls. IgAN patients showed moderate proteinuria (1.1+/−0.2 g/day); however, the control group did not show any proteinuria. Immunoreactivity of intrarenal hemeoxygenase-1 and angiotensinogen in IgAN were significantly increased compared to normal kidneys (2.42+/−0.42 vs 1.00+/−0.26 for hemeoxygenase-1 and 4.05+/−0.40 vs 1.00+/−0.21 for angiotensinogen, arbitrary unit). Even though these IgAN patients did not show massive renal damage, hemeoxygenase-1 and angiotensinogen immunoreactivity were increased in these patients at this time point. These data suggest that activated intrarenal reactive oxygen species-angiotensinogen axis plays some roles in development of IgAN at the early stage and will provide supportive foundation of effectiveness of the renin-angiotensin system blockade in IgAN.

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Relationship between tonsils and IgA nephropathy as well as indications of tonsillectomy

Cited by 108 publications

References 56 publications

Cigarette smoking and chronic kidney diseases

Cigarette smoking and chronic kidney diseases

The efficacy of tonsillectomy on clinical remission and relapse in patients with IgA nephropathy: a randomized controlled trial

Enhanced intrarenal oxidative stress and angiotensinogen in IgA nephropathy patients

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