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Author Spotlight: Investigating the Potential of Chinese Herbal Medicinal Active Dioscin in Treating IgA Nephropathy
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Tonsillectomy Monotherapy for IgA Nephropathy: A Case Series.

Hirokazu Marumoto, Nobuo Tsuboi, Tetsuya Kawamura

    Kidney Medicine
    |October 22, 2020
    PubMed
    Summary

    Tonsillectomy monotherapy may stabilize kidney function in immunoglobulin A nephropathy (IgAN) patients with progressive disease. This study found improved estimated glomerular filtration rate slopes after tonsillectomy, even without corticosteroids.

    Keywords:
    IgA nephropathyhematuriaproteinuriaremissiontonsillectomy

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    Area of Science:

    • Nephrology
    • Immunology
    • Otolaryngology

    Background:

    • Immunoglobulin A nephropathy (IgAN) is a common cause of chronic kidney disease.
    • Corticosteroid therapy combined with tonsillectomy shows therapeutic benefit in IgAN.
    • The efficacy of tonsillectomy as a standalone treatment for IgAN remains unclear.

    Purpose of the Study:

    • To evaluate the effectiveness of tonsillectomy monotherapy in patients with IgAN.
    • To assess the impact of tonsillectomy on kidney function in IgAN patients not receiving concurrent corticosteroids.

    Main Methods:

    • Retrospective analysis of 20 Japanese patients with biopsy-proven IgAN treated with tonsillectomy monotherapy between 2007 and 2018.
    • Comparison of clinical parameters, including kidney function slope (eGFR), before and after tonsillectomy.
    • Patients received renin-angiotensin-aldosterone system inhibitors; 17 had prior corticosteroid therapy.

    Main Results:

    • Significant improvement in the estimated glomerular filtration rate (eGFR) slope observed post-tonsillectomy (-2.59 to 1.05 mL/min/1.73 m²/year; P < .001).
    • Positive effects on eGFR slope were consistent in patients with reduced GFR (eGFR < 60 mL/min/1.73 m²).
    • Remission rates for hematuria (76%), proteinuria (59%), and clinical remission (40%) were achieved post-tonsillectomy.

    Conclusions:

    • Tonsillectomy monotherapy may be a viable option for preserving kidney function in select IgAN patients.
    • This approach could benefit patients with progressive kidney disease despite conventional therapies.
    • Further research with larger, controlled studies is needed to confirm these findings.