Guest guest Posted May 20, 2002 Report Share Posted May 20, 2002 Nice abstract Pierre. Two things jump out at me though. 1) Small sample size. 2) Retrospective investigation. Retrospective investigations are generally considered to be inferior to randomized, double-blind clinical investigations. I know that sounds ridiculous because how could someone do such an analysis when it involves tonsillectomy? Tell 100% of the study participants that they had their tonsils removed, while only removing them from 50%? Marty Tonsillectomy For those who are interested, this is the most recent of the studies that do not conclude positive long-term benefits of tonsillectomy. --Pierre P.S. This is only the abstract. Tonsillectomy does not prevent a progressive course in IgA nephropathy. Clin Nephrol 1999 Mar;51(3):147-52 Rasche FM; Schwarz A; Keller F Medical Department II, University Hospital, Ulm, Germany. BACKGROUND: IgA nephropathy, or Berger's disease, is a primary mesangioproliferative glomerulonephritis, usually with a favourable prognosis. PATIENTS AND METHODS: To investigate the effect of tonsillectomy we conducted a retrospective investigation on renal outcome in 55 patients with IgA nephropathy in an outpatient university clinic between 1968 and 1994. Established risk factors for progressive IgA nephropathy were equally distributed in 16 patients subjected to tonsillectomy and in 39 patients without tonsillectomy. Renal survival and impact of risk factors were estimated by Kaplan-Meier analysis and regression model. RESULTS: Seen in terms of the bivariate Kaplan-Meier analysis the probability of renal survival 10 years after biopsy was 0.37 for the 16 patients with tonsillectomy and 0.63 for the 39 patients without tonsillectomy (log-rank test p = 0.49, not significant). In the multivariate regression model with 6 independent clinical covariates, initially high serum creatinine concentration had the strongest impact on renal outcome (p = 0.002), with a hazard ratio of 8.9 (95% CI: 2.3-35.0). Tonsillectomy had no significant influence in the model (p = 0.37), displaying a hazard ratio of 1.7 (95% CI: 0.5-5.7). CONCLUSION: In conclusion, tonsillectomy does not reduce the risk of developing renal failure or prevent a progressive course of IgA nephropathy. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2002 Report Share Posted May 20, 2002 Nice abstract Pierre. Two things jump out at me though. 1) Small sample size. 2) Retrospective investigation. Retrospective investigations are generally considered to be inferior to randomized, double-blind clinical investigations. I know that sounds ridiculous because how could someone do such an analysis when it involves tonsillectomy? Tell 100% of the study participants that they had their tonsils removed, while only removing them from 50%? Marty Tonsillectomy For those who are interested, this is the most recent of the studies that do not conclude positive long-term benefits of tonsillectomy. --Pierre P.S. This is only the abstract. Tonsillectomy does not prevent a progressive course in IgA nephropathy. Clin Nephrol 1999 Mar;51(3):147-52 Rasche FM; Schwarz A; Keller F Medical Department II, University Hospital, Ulm, Germany. BACKGROUND: IgA nephropathy, or Berger's disease, is a primary mesangioproliferative glomerulonephritis, usually with a favourable prognosis. PATIENTS AND METHODS: To investigate the effect of tonsillectomy we conducted a retrospective investigation on renal outcome in 55 patients with IgA nephropathy in an outpatient university clinic between 1968 and 1994. Established risk factors for progressive IgA nephropathy were equally distributed in 16 patients subjected to tonsillectomy and in 39 patients without tonsillectomy. Renal survival and impact of risk factors were estimated by Kaplan-Meier analysis and regression model. RESULTS: Seen in terms of the bivariate Kaplan-Meier analysis the probability of renal survival 10 years after biopsy was 0.37 for the 16 patients with tonsillectomy and 0.63 for the 39 patients without tonsillectomy (log-rank test p = 0.49, not significant). In the multivariate regression model with 6 independent clinical covariates, initially high serum creatinine concentration had the strongest impact on renal outcome (p = 0.002), with a hazard ratio of 8.9 (95% CI: 2.3-35.0). Tonsillectomy had no significant influence in the model (p = 0.37), displaying a hazard ratio of 1.7 (95% CI: 0.5-5.7). CONCLUSION: In conclusion, tonsillectomy does not reduce the risk of developing renal failure or prevent a progressive course of IgA nephropathy. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2002 Report Share Posted May 20, 2002 I agree. That's the problem about tonsillectomy. Everything has to be either retrospective or observational. It's hard to prove or disprove. All the Japanese reports are interesting, but Japan has one of the most homegeneous populations of any country in the world. Since the results of tonsillectomy studies don't seem to have been replicated anywhere else, one has to wonder if there is something special or specific to IgAN within this population. Pierre Re: Tonsillectomy > Nice abstract Pierre. > > Two things jump out at me though. 1) Small sample size. 2) Retrospective investigation. Retrospective investigations are generally considered to be inferior to randomized, double-blind clinical investigations. I know that sounds ridiculous because how could someone do such an analysis when it involves tonsillectomy? Tell 100% of the study participants that they had their tonsils removed, while only removing them from 50%? > > Marty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 20, 2002 Report Share Posted May 20, 2002 I agree. That's the problem about tonsillectomy. Everything has to be either retrospective or observational. It's hard to prove or disprove. All the Japanese reports are interesting, but Japan has one of the most homegeneous populations of any country in the world. Since the results of tonsillectomy studies don't seem to have been replicated anywhere else, one has to wonder if there is something special or specific to IgAN within this population. Pierre Re: Tonsillectomy > Nice abstract Pierre. > > Two things jump out at me though. 1) Small sample size. 2) Retrospective investigation. Retrospective investigations are generally considered to be inferior to randomized, double-blind clinical investigations. I know that sounds ridiculous because how could someone do such an analysis when it involves tonsillectomy? Tell 100% of the study participants that they had their tonsils removed, while only removing them from 50%? > > Marty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 21, 2002 Report Share Posted May 21, 2002 I agree wholeheartedly with you. I mean someone with a migraine for instance, invariably suffers differently from someone else. More research needed into these side effects....seeing my Neph today, who will need to lie down in a dark room when he sees all my questions!!! Tonsillectomy For those who are interested, this is the most recent of the studies that do not conclude positive long-term benefits of tonsillectomy. --Pierre P.S. This is only the abstract. Tonsillectomy does not prevent a progressive course in IgA nephropathy. Clin Nephrol 1999 Mar;51(3):147-52 Rasche FM; Schwarz A; Keller F Medical Department II, University Hospital, Ulm, Germany. BACKGROUND: IgA nephropathy, or Berger's disease, is a primary mesangioproliferative glomerulonephritis, usually with a favourable prognosis. PATIENTS AND METHODS: To investigate the effect of tonsillectomy we conducted a retrospective investigation on renal outcome in 55 patients with IgA nephropathy in an outpatient university clinic between 1968 and 1994. Established risk factors for progressive IgA nephropathy were equally distributed in 16 patients subjected to tonsillectomy and in 39 patients without tonsillectomy. Renal survival and impact of risk factors were estimated by Kaplan-Meier analysis and regression model. RESULTS: Seen in terms of the bivariate Kaplan-Meier analysis the probability of renal survival 10 years after biopsy was 0.37 for the 16 patients with tonsillectomy and 0.63 for the 39 patients without tonsillectomy (log-rank test p = 0.49, not significant). In the multivariate regression model with 6 independent clinical covariates, initially high serum creatinine concentration had the strongest impact on renal outcome (p = 0.002), with a hazard ratio of 8.9 (95% CI: 2.3-35.0). Tonsillectomy had no significant influence in the model (p = 0.37), displaying a hazard ratio of 1.7 (95% CI: 0.5-5.7). CONCLUSION: In conclusion, tonsillectomy does not reduce the risk of developing renal failure or prevent a progressive course of IgA nephropathy. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2002 Report Share Posted May 28, 2002 Re: tonsillectomy > <I don't think IgAN people necessarily are the type that catch everything > that they come in contact with. I certainly never have, at least, not more > than anyone else around me who don't have IgAN.> > > Pierre i have to agree with you there. My whole family has had a really bad flu... all my husbands work mates caught it, the inlaws caught it and both my brother and sister got it.....but me...well i'm the only one with the immune dissorder and i haven't had even a sniffle! > > kaz > Sometimes, I think some of us actually have an enhanced immune system, rather than a weakened one - but that's just me thinking out loud. Pierre Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2002 Report Share Posted May 28, 2002 All, I agree! I've had IGAN for over five years now. I now have 26% kidney function and I haven't been sick once for the last two years. I believe our immune system is better than most! Rick. Re: tonsillectomy Re: tonsillectomy > <I don't think IgAN people necessarily are the type that catch everything > that they come in contact with. I certainly never have, at least, not more > than anyone else around me who don't have IgAN.> > > Pierre i have to agree with you there. My whole family has had a really bad flu... all my husbands work mates caught it, the inlaws caught it and both my brother and sister got it.....but me...well i'm the only one with the immune dissorder and i haven't had even a sniffle! > > kaz > Sometimes, I think some of us actually have an enhanced immune system, rather than a weakened one - but that's just me thinking out loud. Pierre Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2002 Report Share Posted May 28, 2002 I'm the exact opposite. I seem to get every cold virus that I come into contact with (and that's a lot since I have two kids in daycare). Whenever anyone asks me how I am, I either answer: - 'I think I'm getting a cold', or - 'I have a cold', or - 'I'm just getting over a cold.' I was recently told to cut down on the vitamin C I was talking. I has only on 500, but the renal pharmacist suggested cutting it down to 250. That doesn't seem like enough, but I'll go along with her, and see if I catch even more viruses (if that's possible). There's been talk about green tea, so maybe I'll give that a try. Curtis in Ontario, Canada Re: tonsillectomy Re: tonsillectomy > <I don't think IgAN people necessarily are the type that catch everything > that they come in contact with. I certainly never have, at least, not more > than anyone else around me who don't have IgAN.> > > Pierre i have to agree with you there. My whole family has had a really bad flu... all my husbands work mates caught it, the inlaws caught it and both my brother and sister got it.....but me...well i'm the only one with the immune dissorder and i haven't had even a sniffle! > > kaz > Sometimes, I think some of us actually have an enhanced immune system, rather than a weakened one - but that's just me thinking out loud. Pierre Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2002 Report Share Posted May 28, 2002 I don't know how healthy green tea is, but it tastes good, and that's good enough for me.If you ever get the chance, give green tea ice-cream a try. You'll thank me for it. On the other hand, my grandma and grandpa both drink green tea every day. Apparently its another of the foods that " might or might not " help in some way. (good thing it tastes so good) Did I mention that I am currently living in Japan. No bias uttered at all........ :-) Re: tonsillectomy > > > > <I don't think IgAN people necessarily are the type that catch everything > > that they come in contact with. I certainly never have, at least, not more > > than anyone else around me who don't have IgAN.> > > > > Pierre i have to agree with you there. My whole family has had a really > bad flu... all my husbands work mates caught it, the inlaws caught it and > both my brother and sister got it.....but me...well i'm the only one with > the immune dissorder and i haven't had even a sniffle! > > > > kaz > > > > Sometimes, I think some of us actually have an enhanced immune system, > rather than a weakened one - but that's just me thinking out loud. > Pierre > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2002 Report Share Posted May 28, 2002 RE: tonsillectomy > I'm the exact opposite. I seem to get every cold virus that I come into > contact with (and that's a lot since I have two kids in daycare). Whenever > anyone asks me how I am, I either answer: > - 'I think I'm getting a cold', or > - 'I have a cold', or > - 'I'm just getting over a cold.' > > I was recently told to cut down on the vitamin C I was talking. I has only > on 500, but the renal pharmacist suggested cutting it down to 250. That > doesn't seem like enough, but I'll go along with her, and see if I catch > even more viruses (if that's possible). There's been talk about green tea, > so maybe I'll give that a try. > > Curtis in Ontario, Canada > Hi Curtis. Since we're both in Ontario, I thought you might be interested in this, re vitamin C. The special renal failure multivitamin, Diavites i think they were called, haven't been available in Canada since at least late last summer, and there is still no replacement on the market (to my knowledge anyway, I don't think the new one is available yet). So, the nephrology teams are recommending " son B-complex with Vitamin C " for all their renal failure patients, at least here in Ottawa. It's a temporary measure. Anyway, the vitamin C content is 250 mg. They say it's higher than ideal, but it's Ok. The say the main problem with higher doses of vit C is the formation of kidney stones. The reason for the special vits is that they don't want people taking ordinary multivites due to the vitamin A. Pierre Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 28, 2002 Report Share Posted May 28, 2002 Thanks for the tip, Pierre. I'll check it out. Curtis Re: tonsillectomy RE: tonsillectomy > I'm the exact opposite. I seem to get every cold virus that I come into > contact with (and that's a lot since I have two kids in daycare). Whenever > anyone asks me how I am, I either answer: > - 'I think I'm getting a cold', or > - 'I have a cold', or > - 'I'm just getting over a cold.' > > I was recently told to cut down on the vitamin C I was talking. I has only > on 500, but the renal pharmacist suggested cutting it down to 250. That > doesn't seem like enough, but I'll go along with her, and see if I catch > even more viruses (if that's possible). There's been talk about green tea, > so maybe I'll give that a try. > > Curtis in Ontario, Canada > Hi Curtis. Since we're both in Ontario, I thought you might be interested in this, re vitamin C. The special renal failure multivitamin, Diavites i think they were called, haven't been available in Canada since at least late last summer, and there is still no replacement on the market (to my knowledge anyway, I don't think the new one is available yet). So, the nephrology teams are recommending " son B-complex with Vitamin C " for all their renal failure patients, at least here in Ottawa. It's a temporary measure. Anyway, the vitamin C content is 250 mg. They say it's higher than ideal, but it's Ok. The say the main problem with higher doses of vit C is the formation of kidney stones. The reason for the special vits is that they don't want people taking ordinary multivites due to the vitamin A. Pierre Quote Link to comment Share on other sites More sharing options...
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