Tonsillectomy Delays Progression of Advanced IgA Nephropathy to End-Stage Kidney Disease

Figures & data

Table 1. Comparison of clinical syndromes at initial presentation.

	No. of patients (%)
Clinical syndromes	ESKD (n = 46)	Non-ESKD (n = 319)	p-Value
Asymptomatic hematuria and/or proteinuria	6 (13.0)	162 (50.8)	<0.001*
Macroscopic hematuria	4 (8.7)	59 (18.5)	0.101
Acute nephritic syndrome	2 (4.3)	24 (7.5)	0.433
Chronic nephritic syndrome	19 (41.3)	53 (16.6)	<0.001*
Rapidly progressive nephritic syndrome	2 (4.3)	1 (0.3)	0.051
Nephrotic syndrome	13 (28.3)	20 (6.3)	<0.001*

Note: *Statistically significant.

Table 2. Baseline characteristics of patients.

	Total Patient (n = 46)	Patient with tonsillectomy (n = 15)	Patient without tonsillectomy (n = 31)	p-Value^a
Age (years)	34.8 ± 12.9	31.8 ± 9.94	36.3 ± 14.0	0.277
Gender (M/F)	24/22	7/8	17/14	0.603
Body mass index (kg/m^2)	22.7 ± 3.11	22.0 ± 2.79	23.0 ± 3.23	0.359
Systolic BP (mmHg)	136.0 ± 20.5	133.7 ± 23.4	137.1 ± 19.3	0.611
Diastolic BP (mmHg)	84.0 ± 14.2	85.3 ± 13.7	83.4 ± 14.6	0.656
Proteinuria (g/day)	2.77 ± 1.77	2.65 ± 2.29	2.82 ± 1.50	0.765
Serum creatinine (mg/dL)	1.30 ± 0.85	1.17 ± 0.48	1.36 ± 0.98	0.505
Creatinine clearance (mL/min)	64.8 ± 25.9	62.6 ± 22.4	65.8 ± 27.8	0.697
Serum blood urea nitrogen (mg/dL)	21.0 ± 6.52	19.4 ± 5.52	21.8± 6.89	0.241
Serum uric acid (mg/dL)	6.71 ± 1.66	7.21 ± 2.36	6.54 ± 1.36	0.276
Serum albumin (g/dL)	3.57 ± 0.56	3.59 ± 0.61	3.57 ± 0.54	0.873
Serum total cholesterol (mg/dL)	239.7 ± 79.2	225.2 ± 56.0	247.0 ± 88.5	0.391
Serum IgA	346.3 ± 97.7	318.0 ± 86.4	358.2 ± 101.0	0.217
Serum C3	92.4 ± 18.4	92.7 ± 22.9	92.3 ± 16.8	0.943
Histological grade (1/2/3/4)	0/0/20/26	0/0/7/8	0/0/13/18	0.762
Steroid therapy	7	3	4	0.667
RAS-I	5	1	4	0.895
Duration from diagnosis to ESKD (years)	7.0 ± 5.1	9.8 ± 6.0	5.8 ± 4.0	0.007*

Notes: Histological grades in both groups compared using Pearson’s χ²-test.

^aData compared using Mann–Whitney U-test, unpaired t-test, and χ²-test.

*Statistically significant.

Figure 1. Relationship between age at diagnosis and at ESKD in patients.

Notes: Patients with (▪) and without (□) tonsillectomy. Slopes of lines show ratio of age at ESKD to that at diagnosis (with tonsillectomy, large broken line; age at diagnosis = 1.29 × age at diagnosis; patients without tonsillectomy, small broken line; age at ESKD = 1.13 × age at diagnosis).

Figure 2. Comparison of renal survival between patients with and without tonsillectomy.

Note: Kaplan–Meier curves significantly differ (p = 0.007; log-rank test).

Table 3. Logistic regression analysis of factors affecting ESKD progression within 7 years in 46 patients with IgAN.

Variable	Odds ratio	95% CI	p-Value
Age/10 years	0.59	0.27–1.28	0.184
Systolic BP/10 mmHg	0.71	0.46–1.08	0.105
Urinary protein/g/day	1.78	0.83–3.82	0.139
Serum creatinine/0.5 mg/dL	14.4	1.41–147.7	0.025*
Histology Grade 4 versus Grade 3	29.2	3.14–271.9	0.003*
Tonsillectomy versus no tonsillectomy	0.09	0.01–0.75	0.026*
Steroid therapy versus no steroid therapy	0.64	0.06–7.51	0.723

Note: *Statistically significant.