Prognostic Factors of IgA Nephropathy after Tonsillectomy

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  • Tabata Takahisa
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Ohbuchi Toyoaki
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Kitamura Takuro
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Ohkubo Jun-ichi
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Hashida Koichi
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Hohchi Nobusuke
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Wakasugi Tetsuro
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Katoh Akiko
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health
  • Suzuki Hideaki
    Department of Otorhinolaryngology, School of Medicine, University of Occupational and Environmental Health

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Other Title
  • 口蓋扁桃摘出術を行ったIgA腎症の予後因子
  • コウガイ ヘントウ テキシュツジュツ オ オコナッタ IgAジンショウ ノ ヨゴ インシ

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Abstract

Tonsillectomy is one of the prevailing treatments for IgA nephropathy. This retrospective study aimed to elucidate prognostic factors for the postoperative kidney function of tonsillectomized patients with IgA nephropathy. Forty consecutive patients with IgA nephropathy who underwent tonsillectomy in our department between 1999 and 2008 were enrolled. They were 21 men and 19 women with ages ranging 14-52 years with an average age of 25.5 years. The patients were classified into remission and non-remission groups based on their kidney function assessed 1 year after surgery according to the clinical guidelines for IgA nephropathy of the Japanese Society of Nephrology. Patients' profiles and preoperative physical findings/laboratory data in the remission group were then compared with those in the non-remission group.<br>The remission and non-remission groups included 13 and 27 patients, respectively. The remission group showed a significantly shorter interval between onset to surgery (2.3±2.1 vs. 5.0±6.7 years; p=0.032), a lower diastolic blood pressure (66±13 vs. 75±17 mmHg; p=0.040), a higher level of serum total protein (7.6±0.5 vs. 7.0±0.7 mg/dl; p=0.015), and a higher degree of tonsillar hypertrophy (Io: IIo: IIIo=5: 8: 0 vs. 21: 6: 0; p=0.033) in comparison with the non-remission group. Multiple logistic regression analysis also revealed that patients with a higher level of serum total protein and those with a higher degree of tonsillar hypertrophy were more likely to recover. We should carefully consider these prognostic factors when indicating tonsillectomy for the treatment of IgA nephropathy.

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