title: Long-term efficacy of tonsillectomy as a treatment in patients with IgA nephropathy: a meta-analysis.
abstract: OBJECTIVE
  IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide and will lead some unfavorable outcomes such as end-stage renal disease. The efficacy of tonsillectomy remains controversial in both Asian and Caucasian ethnicity. Our meta-analysis was aiming at exploring its long-term efficacy and providing further evidences for clinical treatment.
  
  
  METHODS
  Prospective and retrospective studies that compared the rate of clinical remission and/or end-stage renal disease in IgAN patients who applied tonsillectomy were involved in our meta-analysis. The online databases we searched were PubMed, Embase, Cochrane Library, and Web of Science RESULTS: Nineteen studies with a total of 3483 participants are involved in our meta-analysis. It is found that treatment of tonsillectomy is significantly associated with a higher rate of clinical remission (15 studies, 3059 participants; pooled OR 3.30, 95 % CI 2.47-4.40). Meanwhile, tonsillectomy shows positive effect on refraining from developing end-stage renal disease (9 studies, 1804 participants; pooled OR 0.33, 95 % CI 0.16-0.69). In following two subgroup analyses, we integrate studies with more than 5 years of follow-up from clinical remission group and end-stage renal disease group. Both of them show that tonsillectomy has favorable long-term efficacy, pooled OR 3.37 (95 % CI 2.68-4.24) and 0.20 (95 % CI 0.12-0.33), respectively.
  
  
  CONCLUSIONS
  Long-term efficacy of tonsillectomy indicates that this treatment is helpful in inducing clinical remission and inhibiting development of end-stage renal disease in patients with IgAN and should be considered for addition into standard clinical treatment.
authors.affiliation: Department of Nephrology, First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Jiayu
authors.initials: J
authors.lastname: Duan
authors.affiliation: Department of Nephrology, First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan, China.
authors.forename: Dongwei
authors.initials: D
authors.lastname: Liu
authors.affiliation: Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, Xinxiang Medical University Xinxiang, Xinxiang, Henan, China. gcduan@zzu.edu.cn.
authors.forename: Guangcai
authors.initials: G
authors.lastname: Duan
authors.affiliation: Department of Nephrology, First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, Henan, China. zhangsuoliu@sina.com.
authors.forename: Zhangzuo
authors.initials: Z
authors.lastname: Liu
mesh_terms: D005922:Glomerulonephritis, IGA / Q000150:complications / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors; D014068:Tonsillectomy; D016896:Treatment Outcome
keywords: Clinical remission; End-stage renal disease; Glomerulonephritis; IgA nephropathy; Meta-analysis; Tonsillectomy