LONG-TERM EFFECTS OF INTENSIVE THERAPY COMBINED WITH TONSILLECTOMY INPATIENTS WITH IGA NEPHROPATHY

IgA nephropathy (IgAN) is the most common form of glomerular disease i n the world. However, there is currently no established therapy for Ig AN. To assess treatment regimens for IgAN, we investigated a retrospec tive long-term follow-up study comparing an intensive therapy with a c onventional therapy. Clinical outcomes 5 years after the initiation of treatment in two centers were compared. In one center, patients were treated with tonsillectomy combined with steroid pulse, cyclophosphami de, anti-platelet drugs and warfarin (intensive therapy group, Group A , n = 50). In the other center, patients were treated with anti-platel et drugs, warfarin or no treatment (conventional therapy group, Group B, n = 50). At the beginning of treatment, the two groups were well ma tched in terms of age, sex, blood pressure, urinalysis, and creatinine clearance. Five years after the initiation of treatment, proteinuria was remarkably reduced from 1.6 g/day to 0.5 g/day in Group A, whereas no significant change in proteinuria was observed in Group B. Creatin ine clearance significantly improved from 77.6 ml/min to 89.4 ml/min i n Group A, whereas creatinine clearance deteriorated from 70.9 ml/min to 62.5 ml/min during 5 years in Group B. Our results indicate that ea rly intensive therapy for IgAN is potentially of great value, and warr ants dose investigation.