title: The efficacy of tonsillectomy on clinical remission and relapse in patients with IgA nephropathy: a randomized controlled trial.
abstract: BACKGROUND
  The efficacy of tonsillectomy in immunoglobulin A nephropathy (IgAN) remains controversial. The aim of the study was to conduct a randomized controlled trial to evaluate the effect of tonsillectomy in patients with IgAN.
  
  
  METHODS
  We randomly selected 98 patients with biopsy-proven IgA nephropathy and randomly allocated to receive tonsillectomy combined with drug therapy (Group A) or drug therapy alone (Group B). The participating patients were entered into a 4-year single-center study. Remission and relapse rate were calculated for hematuria and proteinuria using the Kaplan-Meier method.
  
  
  RESULTS
  No differences were found between the two groups in their baseline clinical and histological characteristics. Patients with tonsillectomy exhibited considerable improvement in the following aspects compared to those patients who did not undergo tonsillectomy: time to reach first remission (3.1 vs. 24.9 months, p < 0.001) for hematuria and (2.5 vs. 26.1 months, p < 0.001) for proteinuria, cumulative remission rate (91.8% vs. 46.9%, p < 0.001 by log-rank test) for hematuria and (95.9% vs. 51.0%, p < 0.001) for proteinuria, the duration of first remission (26.5 vs. 11.8 months, p = 0.0047) for hematuria and (23.5 vs. 10.5 months, p = 0.0012) for proteinuria, as well as lower relapse rate for hematuria and proteinuria in Group A.
  
  
  CONCLUSIONS
  Our clinical data demonstrated that tonsillectomy could be beneficial for IgAN patients, particularly by contributing to faster and longer remission, as well as reducing the frequency of possible future relapses.
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Danyi
authors.initials: D
authors.lastname: Yang
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Liyu
authors.initials: L
authors.lastname: He
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Peng
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Youming
authors.initials: Y
authors.lastname: Peng
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Shuguang
authors.initials: S
authors.lastname: Yuan
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Yinghong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Xian
authors.initials: X
authors.lastname: Chen
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Fuyou
authors.initials: F
authors.lastname: Liu
authors.affiliation: a Department of Nephrology, The Second Xiangya Hospital, Key Lab of Kidney Disease and Blood Purification in Hunan , Central South University , Changsha , Hunan , People's Republic of China.
authors.forename: Chan
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D005260:Female; D005922:Glomerulonephritis, IGA / Q000601:surgery*; D006417:Hematuria; D006801:Humans; D008297:Male; D011507:Proteinuria; D012008:Recurrence; D012074:Remission Induction; D014068:Tonsillectomy; D016896:Treatment Outcome
keywords: Clinical remission; IgA nephropathy; mucosal immunity; relapse; tonsillectomy