title: Tonsillectomy in a European Cohort of 1,147 Patients with IgA Nephropathy.
abstract: BACKGROUND
  Tonsillectomy has been considered a treatment for IgA nephropathy (IgAN). It is aimed at removing a source of pathogens, reducing mucosa-associated lymphoid tissue and decreasing polymeric IgA synthesis. However, its beneficial effect is still controversial. In Asia, favorable outcomes have been claimed mostly in association with corticosteroids. In Europe, small, single-center uncontrolled studies have failed to show benefits.
  
  
  METHODS
  The European validation study of the Oxford classification of IgAN (VALIGA) collected data from 1,147 patients with IgAN over a follow-up of 4.7 years. We investigated the outcome of progression to end-stage renal disease (ESRD) and/or 50% loss of estimated glomerular filtration rate (eGFR) and the annual loss of eGFR in 61 patients who had had tonsillectomy.
  
  
  RESULTS
  Using the propensity score, which is a logistic regression model, we paired 41 patients with tonsillectomy and 41 without tonsillectomy with similar risk of progression (gender, age, race, mean blood pressure, proteinuria, eGFR at renal biopsy, previous treatments and Oxford MEST scores). No significant difference was found in the outcome. Moreover, we performed an additional propensity score pairing 17 patients who underwent tonsillectomy after the diagnosis of IgAN and 51 without tonsillectomy with similar risk of progression at renal biopsy and subsequent treatments. No significant difference was found in changes in proteinuria, or in the renal end point of 50% reduction in GFR and/or ESRD, or in the annual loss of eGFR.
  
  
  CONCLUSIONS
  In the large VALIGA cohort of European subjects with IgAN, no significant correlation was found between tonsillectomy and renal function decline.
authors.forename: John
authors.initials: J
authors.lastname: Feehally
authors.forename: Rosanna
authors.initials: R
authors.lastname: Coppo
authors.forename: Stéphan
authors.initials: S
authors.lastname: Troyanov
authors.forename: Shubha S
authors.initials: SS
authors.lastname: Bellur
authors.forename: Daniel
authors.initials: D
authors.lastname: Cattran
authors.forename: Terence
authors.initials: T
authors.lastname: Cook
authors.forename: Ian S D
authors.initials: IS
authors.lastname: Roberts
authors.forename: Jacobien C
authors.initials: JC
authors.lastname: Verhave
authors.forename: Roberta
authors.initials: R
authors.lastname: Camilla
authors.forename: Luca
authors.initials: L
authors.lastname: Vergano
authors.forename: Jesus
authors.initials: J
authors.lastname: Egido
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiecek
authors.forename: Henryk
authors.initials: H
authors.lastname: Karkoszka
authors.forename: Vladimir
authors.initials: V
authors.lastname: Tesar
authors.forename: Dita
authors.initials: D
authors.lastname: Maixnerova
authors.forename: Mai
authors.initials: M
authors.lastname: Ots-Rosenberg
authors.forename: Marco
authors.initials: M
authors.lastname: Quaglia
authors.forename: Cristiana
authors.initials: C
authors.lastname: Rollino
authors.forename: Riccardo
authors.initials: R
authors.lastname: Magistroni
authors.forename: Stefano
authors.initials: S
authors.lastname: Cusinato
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cravero
authors.forename: Licia
authors.initials: L
authors.lastname: Peruzzi
authors.forename: Sigrid
authors.initials: S
authors.lastname: Lundberg
authors.forename: Loreto
authors.initials: L
authors.lastname: Gesualdo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cancarini
authors.forename: Sandro
authors.initials: S
authors.lastname: Feriozzi
authors.forename: Franco
authors.initials: F
authors.lastname: Ferrario
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D018450:Disease Progression; D005006:Ethnicity; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D012737:Sex Factors; D014068:Tonsillectomy / Q000706:statistics & numerical data*; D016896:Treatment Outcome