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Effect of tonsillectomy and its timing on renal outcomes in Caucasian IgA nephropathy patients

  • Nephrology - Original Paper
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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 m2 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.

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Acknowledgments

The authors are grateful for the advice of Prof. John Feehally during preparation of this manuscript. The study was supported by SROP-4.2.2/B-10/1/2010-0029 Supporting Scientific Training of Talented Youth at the University of Pécs. Dr Kovesdy is supported by grant 1R01DK096920-01 from the NIH/NIDDK. Dr. Kovesdy is an employee of the US Department of Veterans Affairs. Opinions expressed in this paper are those of the authors, and do not necessarily represent the opinion of the US Department of Veterans Affairs.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 2nd Department of Internal Medicine and Nephrological Center, Clinical Center, University of Pécs, Pacsirta Str. 1, Pecs, 7624, Hungary

    Tibor Kovács, Tibor Vas, Péter Degrell, István Wittmann & Judit Nagy

  2. University of Tennessee Health Science Center and Memphis VA Medical Center, Memphis, TN, USA

    Csaba P. Kövesdy

  3. Department of Otolaryngology, Clinical Center, University of Pécs, Pecs, Hungary

    Györgyi Nagy

  4. Department of Laboratory Medicine, Clinical Center, University of Pécs, Pecs, Hungary

    Zsuzsanna Rékási

Authors
  1. Tibor Kovács
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  2. Tibor Vas
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  3. Csaba P. Kövesdy
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  4. Péter Degrell
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  5. Györgyi Nagy
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  6. Zsuzsanna Rékási
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  7. István Wittmann
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  8. Judit Nagy
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Corresponding author

Correspondence to Judit Nagy.

Additional information

Tibor Kovács and Tibor Vas have contributed equally to this work.

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Kovács, T., Vas, T., Kövesdy, C.P. et al. Effect of tonsillectomy and its timing on renal outcomes in Caucasian IgA nephropathy patients. Int Urol Nephrol 46, 2175–2182 (2014). https://doi.org/10.1007/s11255-014-0818-7

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  • DOI: https://doi.org/10.1007/s11255-014-0818-7

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