The Effect On The Prognosis Of Tonsillectomy Of Patients With IgA Nephropathy

Background: IgA nephropathy is the most common glomerular disease worldwide,and it is the most common cause of chronic renal failure in China.Due to the onset of IgA nephropathy is unknown,pathological type of complex factors,factors affecting the prognosis of patients is also unclear.For these reasons,there is currently no uniform solution for the treatment of IgA nephropathy.Among them,tonsillectomy has been a more controversial treatment at home and abroad.This study collected and summarized the clinical data and treatment plan of patients with IgA nephropathy,and explored the effect of tonsillectomy on the prognosis of patients with IgA nephropathy.Method: A total of 83 patients with IgA nephropathy and chronic tonsillitis were first admitted to the First Affiliated Hospital of China Medical University from January 1,2012 to December 31,2015.The patient's age,gender,serum albumin,serum creatinine,24-hour urine protein quantitation,urinary blood cell level,abnormal morphological red blood cells,high blood pressure,renal biopsy pathological data,and treatment plan were collected.And conduct a retrospective study.Result: 1.Among the 83 patients,42 were male(50.6%)and 41 were female(49.4%),with an average age of 32.7 ± 10.1 years.Among them,34 patients underwent tonsillectomy,20 males(58.8%)and 14 females(41.2%).The mean follow-up time was 46.9 ± 13.7 months.2.Multivariate ordered logistic regression: No indicators were found to be independent risk factors for the prognosis of patients with IgAN.3.Multivariate COX analysis: When eGFR <50ml/min/1.73m2 or 24-hour urine protein quantitation >3.0g at baseline,the patient was found to have a poor prognosis(p<0.05);while endothelial cell proliferation occurred in renal biopsy pathology,suggesting that the prognosis may be better than in patients without endothelial cell proliferation(p < 0.05).Patients with tonsillectomy may have a better prognosis than who have not undergone tonsillectomy(p<0.05);when patients with IgA nephropathy who have not received hormone therapy may have a higher prognosis than who receive hormone therapy(p<0.05).The differences were statistically significant.4.Kaplan-Meier survival analysis: As the follow-up time prolonged,the survival time of patients with IgA nephropathy who underwent tonsillectomy was significantly longer than that of patients who did not undergo tonsillectomy.The difference between the two groups was statistically significant(p<0.05).Conclusion: 1.Increased serum creatinine levels and 24-hour urine protein levels suggest a poor prognosis,whereas endothelial cell proliferation suggests a better prognosis.2.Patients with IgA nephropathy and chronic tonsillitis undergoing tonsillectomy may have a better prognosis.