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Tonsillectomy combined with steroid pulse therapy for patients with immunoglobulin a nephropathy: A meta-analysis

Linping Xiong*

Tonsillectomy combined with steroid pulse therapy has been reported to be effective in decreasing urinary abnormalities and preventing the progressive deterioration of renal function in patients with Immunoglobulin a nephropathy. However, the efficacy of the therapy remains controversial. We conducted a meta-analysis to assess the efficacy of tonsillectomy combined with steroid pulse therapy in achieving clinical remission. Studies from PubMed and Cochrane were searched up to the 20th of February 2017. Retrospective cohort studies, which reported tonsillectomy combined with steroid pulse therapy in patients with Immunoglobulin A nephropathy, were included. The fixed effect model was used to calculate the pooled hazard ratio. Finally, 7 retrospective cohort studies were included for analysis, with a total of 1474 participants. The pooled hazard ratio was 2.87 (95% confidence interval: 2.19- 3.77), comparing those who underwent tonsillectomy combined with steroid pulse therapy and those who did not. The subgroup analysis, sensitivity analysis and publication bias test suggested the overall result of the analysis was robust. The meta-analysis concludes that tonsillectomy combined with steroid pulse therapy has a significant effect on increasing the probability of clinical remission.