title: Effect of tonsillectomy and its timing on renal outcomes in Caucasian IgA nephropathy patients.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 2nd Department of Internal Medicine and Nephrological Center, Clinical Center, University of Pécs, Pacsirta Str. 1, Pecs, 7624, Hungary.
authors.forename: Tibor
authors.initials: T
authors.lastname: Kovács
authors.forename: Tibor
authors.initials: T
authors.lastname: Vas
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kövesdy
authors.forename: Péter
authors.initials: P
authors.lastname: Degrell
authors.forename: Györgyi
authors.initials: G
authors.lastname: Nagy
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Rékási
authors.forename: István
authors.initials: I
authors.lastname: Wittmann
authors.forename: Judit
authors.initials: J
authors.lastname: Nagy
mesh_terms: D000328:Adult; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D008297:Male; D061646:Operative Time; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods*; D044465:White People