PROTEINURIA-STRATIFIED RESPONSE TO COMBINED TONSILLECTOMY AND STEROID PULSE THERAPY IN IGA NEPHROPATHY
Keywords:
IgA nephropathy, tonsillectomy, steroid pulse therapy, proteinuria, renal function preservationAbstract
IgA nephropathy is the most common primary glomerulonephritis, characterized by IgA deposition in the glomerular mesangium. Proteinuria is a critical prognostic factor in disease progression. Current treatment approaches include supportive care and immunosuppressive therapy. Tonsillectomy combined with steroid pulse therapy has emerged as a potential treatment strategy, based on the hypothesis that tonsils play a role in disease pathogenesis and that targeting both mucosal and systemic immune responses may yield synergistic benefits. This study aimed to evaluate the efficacy of combined tonsillectomy and steroid pulse therapy in IgA nephropathy patients, with a focus on outcomes based on initial proteinuria status. Recent clinical studies have demonstrated that combined tonsillectomy and steroid pulse therapy may be superior to monotherapy in achieving clinical remission and preserving renal function. The efficacy appears to be influenced by baseline proteinuria levels, with patients presenting moderate to severe proteinuria showing more pronounced benefits. Long-term follow-up data suggest improved renal survival and sustained proteinuria reduction in patients undergoing combination therapy. However, the optimal timing of intervention and patient selection criteria remain areas of active investigation. The treatment approach must be balanced against potential risks, including surgical complications from tonsillectomy and adverse effects of steroid therapy. Combined tonsillectomy and steroid pulse therapy shows promise as a treatment strategy for IgA nephropathy, particularly in patients with moderate to severe proteinuria. Further research is needed to refine patient selection criteria and optimize long-term outcomes.
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