Effect of tonsillectomy and its timing on renal outcomes in Caucasian IgA nephropathy patients.
Int Urol Nephrol
; 46(11): 2175-82, 2014 Nov.
Article
em En
| MEDLINE
| ID: mdl-25181956
ABSTRACT
PURPOSE:
The role of tonsillectomy in the treatment of IgA nephropathy in Caucasian patients is controversial.METHODS:
A retrospective cohort study was conducted in 264 patients with biopsy-proven primary IgA nephropathy to examine the association between tonsillectomy and long-term renal survival, defined as the incidence of estimated glomerular filtration rates (eGFRs) of ≤30 ml/min/1.73 m(2) or end-stage renal disease (the composite of initiation of dialysis treatment or renal transplantation). The association of tonsillectomy with renal end-points was examined using the Kaplan-Meier method and Cox models.RESULTS:
One-hundred and sixty-six patients did not undergo tonsillectomy (Group I, follow-up 130 ± 101 months) and 98 patients underwent tonsillectomy (Group II, follow-up 170 ± 124 months). The mean renal survival time was significantly longer for both end-points between those patients who underwent tonsillectomy (Group II) versus patients without tonsillectomy (Group I) (p < 0.001 and p = 0.005). The mean renal survival time was significantly longer for both end-points between those patients who had macrohaematuric episodes versus patients who had no macrohaematuric episodes (p = 0.035 and p = 0.019). Tonsillectomy, baseline eGFR and 24-h proteinuria were independent risk factors for both renal end-points.CONCLUSION:
Tonsillectomy may delay the progression of IgA nephropathy mainly in IgA nephropathy patients with macrohaematuria. Prospective investigation of the protective role of tonsillectomy in Caucasian patients is needed.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Tonsilectomia
/
População Branca
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Glomerulonefrite por IGA
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article