%0 Journal Article %T A comparison of the clinical efficacy of tonsillectomy with steroid pulse therapy and tonsillectomy therapy alone for patients with immunoglobulin A nephropathy: a retrospective observational study. %A Sato R %A Wakisaka R %A Komatsuda H %A Yamaki H %A Ohara K %A Kumai T %A Kishibe K %A Nakagawa N %A Hayashi T %A Takahara M %J Clin Exp Nephrol %V 0 %N 0 %D 2024 Jun 18 %M 38888720 %F 2.617 %R 10.1007/s10157-024-02527-1 %X BACKGROUND: Tonsillectomy with steroid pulse therapy (TSP) and tonsillectomy monotherapy (T) have improved the prognosis of patients with immunoglobulin A nephropathy (IgAN). However, a consensus has not been reached on the best treatment for these patients. This study aimed to compare the efficacies of TSP and T.
METHODS: Data of patients with IgAN who received TSP or T were retrospectively analyzed. The exclusion criterion was a serum creatinine level > 1.5 mg/dL. The clinical remission and renal survival rates were compared.
RESULTS: Patients were divided into groups based on the treatment method: the TSP (n = 82) and T groups (n = 41). No significant differences were observed in patient characteristics, except for the observation period (TSP: 60 months, T: 113 months). The log-rank test revealed that the clinical remission rate was significantly higher in the TSP group than in the T group (p < 0.05). The superiority of TSP was also observed in the urinary protein excretion (> / = or < 1 g/day) of the two subgroups. According to the Cox proportional-hazards model, the treatment method and daily urinary protein extraction were independent factors affecting clinical remission. The 10-year renal survival rates in the TSP and T groups were 100% and 92.5%, respectively. The log-rank test revealed a tendency for a higher renal survival rate in the TSP group than in the T group (p = 0.09).
CONCLUSIONS: The clinical remission rate was significantly higher with TSP than with T, regardless of urinary protein levels. TSP tended to have a better renal survival rate than T.