Long‐term outcomes of tonsillectomy for I g A nephropathy patients: A retrospective cohort study, two‐centre analysis with the inverse probability therapy weighting method

• Published in: Nephrology (Carlton, Vic.) Vol. 23; no. 9; pp. 846 - 854
• Main Authors: Matsumoto, Keiichiro, Ikeda, Yuki, Yamaguchi, Sae, Sanematsu, Mai, Fukuda, Makoto, Takashima, Tsuyoshi, Kishi, Tomoya, Miyazono, Motoaki, Uchiumi, Saori, Yoshizaki, Mai, Nonaka, Yasunori, Matsumoto, Ryoko, Kanaya, Akiko, Fukunari, Kenichi, Ikeda, Yuji
• Format: Journal Article
• Language: English
• Published: 01.09.2018
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.13108

Summary at a Glance The effect of tonsillectomy on I g AN remains controversial. This paper contains important information on this issue, showing the lack of effectiveness of tonsillectomy on long‐term outcome of I g AN. ABSTRACT Aim The effect of tonsillectomy on I g A nephropathy remains controversial. The aim of this study was to compare the effect of tonsillectomy on the outcome, end stage kidney disease ( ESKD ) and all‐cause death in I g A nephropathy patients who did and did not undergo tonsillectomy. Methods All basic data were retrospectively gathered from patients who had undergone renal biopsies at two Japanese clinical centres. Two hundred and twenty‐seven patients were eligible for the study, with a median age of 34 ( I nterquartile range ( IQR ): 25–43) years and median follow‐up of 92 ( IQR : 40–178) months. The primary endpoint was the composite outcome of the onset of ESKD and all‐cause death before ESKD . We performed a C ox proportional hazard regression analysis after adjusting for patient characteristics using the inverse probability therapy weighting ( IPTW ) method and a C ox analysis using the M atching method. Similarly, we analyzed these outcomes in a mild cohort. Results We were unable to find any significant advantages of tonsillectomy in either analysis ( IPTW and matching, HR : 0.40 (0.12–1.36) P  = 0.072 and 0.78 (0.13–4.64) P =  0.786). However, in the mild cohort analysis, our data showed that the Tonsillectomy group tended to be less likely to reach the composite outcomes than the N ot T onsillectomy group with statistical significance (hazard ratio ( HR ), <0.001 [ CI <0.001 to <0.001, P  = 0.039]). Conclusion In this study, our findings led us to conclude that performing tonsillectomy in an early and timely manner may have predisposition of less poor prognosis.