Association of initial prednisolone dose with remission, relapse, and infectious complications in adult-onset minimal change disease.

• Material Type: 博士論文
• Title: Association of initial prednisolone dose with remission, relapse, and infectious complications in adult-onset minimal change disease.
• Author/Editor: Tanabe, Kaori; Samejima, Ken-ichi; Fukata, Fumihiro; Kosugi, Takaaki; Tsushima, Hideo; Morimoto, Katsuhiko; Okamoto, Keisuke; Matsui, Masaru; Eriguchi, Masahiro; Maruyama, Naoki; Akai, Yasuhiro; Tsuruya, Kazuhiko
• Author Heading: Tanabe, Kaori; Samejima, Ken-ichi; Fukata, Fumihiro; Kosugi, Takaaki; Tsushima, Hideo; Morimoto, Katsuhiko; Okamoto, Keisuke; Matsui, Masaru; Eriguchi, Masahiro; Maruyama, Naoki; Akai, Yasuhiro; Tsuruya, Kazuhiko
• Publication, Distribution, etc.: Springer Nature
• Publication Date: 2022-01
• Publication Date (W3CDTF): 2022-01
• Alternative Title: 成人発症の微小変化型ネフローゼ症候群に対するプレドニゾロン初期投与量と，寛解，再発，及び感染症との関連
• Periodical title: Clinical and experimental nephrology
• No. or year of volume/issue: 26 1
• Volume: 26
• Issue: 1
• Pages: 29-35
• ISSN (Periodical Title): ISSN : 1342-1751
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2021-12-21
• Dissertation Number: 甲第803号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Minimal change disease; Prednisolone; Remission induction; Recurrence; Cumulative steroid doses
• Target Audience: 一般
• Note (General): type:Thesis; Background: A dose of 0.5-1 mg/kg/day of prednisolone (PSL) is administered for the initial treatment of minimal change disease (MCD). However, little is known about the optimal PSL dose for the initial treatment of MCD. Methods: We conducted a retrospective multicenter cohort study of treatment-naive adult patients with MCD diagnosed by renal biopsy from 1981 to 2015 in whom PSL monotherapy was performed as the initial treatment. The exposure of interest was an initial median PSL dose of < 0.63 mg/kg/day (Group L) compared to ≥ 0.63 mg/kg/day (Group H). Cumulative remission and relapse after remission were compared between these groups using Cox regression adjusted for baseline characteristics. Results: Ninety-one patients met the inclusion criteria. During a median follow-up of 2.98 years, 87 (95.6%) patients achieved complete remission, and 47.1% relapsed after remission. There was no significant difference in the remission rate between the groups at 4 weeks of follow-up (66.7 vs. 82.6%). The median time to remission in Group L was comparable to that in Group H (17.0 vs. 14.0 days). A multivariable Cox hazard model revealed that the initial PSL dose was not a significant predictor of remission. The cumulative steroid doses at 6 months, 1 year, and 2 years after treatment initiation were significantly lower in Group L than in Group H. Conclusion: The initial PSL dose was not associated with time to remission, remission rate, time to relapse, or relapse rate. Therefore, a low initial steroid dose may be sufficient to achieve remission.; 博士（医学）・甲第803号・令和3年12月21日; © 2021. The Author(s). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.; identifier:Clinical and experimental nephrology Vol.26 No.1 p.29-35 (2022 Jan); identifier:13421751; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3952; identifier:Clinical and experimental nephrology, 26(1): 29-35
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1007/s10157-021-02119-3
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3952/1/01%e7%94%b2803%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3952/2/02%e7%94%b2803%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3952/3/03%e7%94%b2803%e6%9c%ac%e6%96%87.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3952/4/04%e7%94%b2803Suppl..pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3952/5/05%e7%94%b2805Correction.pdf fulltext