We recommended TSP to patients if they had urinary protein > 0.5 g/day continuously. However, we also accepted the desire of patients who wished to receive TSP or tonsillectomy. Treatment methods have

been applied to cases of various degrees of severity, providing us with a sufficient number of study patients. We employed the technique of multivariate analysis to assess the impact of multiple covariates for long-term learn more renal survival (and to exclude potential bias). Gender (male), age (≥40 years), histologically acute + chronic region, dialysis induction risk, and therapeutic option significantly affected renal survival. Conversely, use of ACEIs or ARBs did not influence renal survival. A noteworthy result of our study was that tonsillectomy alone significantly contributed to preservation of renal function. This was proved by comparing Avapritinib chemical structure the T and N groups, both of which did not have a significant difference in clinical and laboratory data (Table 4). Regarding steroid therapy for IgAN, Kobayashi et al. [11] first reported on its efficacy.

Hotta et al. reported the absence of progressive renal dysfunction in 157 IgAN patients that went into so-called ‘clinical remission’ out of 529 patients. Furthermore, they were free of urinary findings after follow-up of ≥ 36 months (average follow-up 82.3 months). Remission was significantly correlated with tonsillectomy and steroid pulse therapy, indicating that it was a potential standard therapy to induce Ketotifen clinical remission [12]. Recently long-term follow-up studies conducted over 10 years were reported concerning the efficacy of tonsillectomy in IgA nephropathy. Akagi et al. [13] and Xie et al. [4] reported that the tonsillectomy

group ‘preserved renal function’ more efficiently than in the non-tonsillectomy group. In Japan where health checkup systems are quite advanced, it is relatively easy to detect early-stage IgAN. Therapeutic interventions such as tonsillectomy, when initiated in early-stage IgAN, are expected to preserve the kidney for a longer period. Moreover, our results showing the inhibitory effect of tonsillectomy on progress of IgAN supports the idea that tonsillectomy alone significantly prolonged survival time of the kidney. According to Katafuchi et al. [14] steroid pulse therapy significantly inhibited the progress of IgAN to terminal renal failure as compared to both non-steroid and oral steroid therapies. These observations were supported by our current study. TSP had the highest impact on inhibiting progression of IgAN. From this observation, it was suggested that tonsillectomy plus steroid pulse therapy was an efficacious therapy to preserve renal function. However, the data of our study provided limited information because this was a retrospective study. In conclusion, combination therapies of tonsillectomy and steroid pulse had the most significant therapeutic impact compared to other therapies.