IgA nephropathy

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Written by Ji Kang
Nephrology
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IgA nephropathy is a disease.

IgA nephropathy is the most common type of primary glomerular disease, caused by the deposition of IgA-dominant immunoglobulins in the glomerular mesangial area. It has a short latency period, with symptoms appearing early. Clinical manifestations of IgA nephropathy are diverse, with approximately 40%-50% of patients experiencing macroscopic hematuria hours to two days after precursor symptoms such as upper respiratory tract infections, and some patients also suffer from severe back pain and abdominal pain. About 30%-40% of patients only present with asymptomatic hematuria or proteinuria. Approximately 5%-20% of patients exhibit severe edema and substantial proteinuria, showing symptoms of nephrotic syndrome. At the onset of the disease, about 10% of patients also have hypertension. As the disease progresses, those with hypertension can exceed 40%. Less than 10% of patients may experience acute renal failure.

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Written by Zhou Qi
Nephrology
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Causes of hematuria in IgA nephropathy

IGA nephropathy is a type of chronic glomerulonephritis. This disease often causes patients to have blood in their urine, and can also lead to visible blood in the urine. The glomerulus is a cluster of capillaries with semi-permeable functions, allowing water and metabolic waste to pass through while preventing proteins and red blood cells from passing. The waste and water pass through the glomerular filtration barrier and enter into the urine, which is the main component of urine. If some pathological cause damages the capillaries of the glomerulus, such as in the case of IGA nephropathy where there is an inflammatory response within the glomerulus, it can damage the glomerular filtration barrier. As a result, red blood cells may pass through the capillary walls of the glomerulus into the urine, causing blood in the urine.

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Written by Niu Yan Lin
Nephrology
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Can patients with IgA nephropathy eat peaches?

Patients with IgA nephropathy vary greatly in the severity of their condition, and whether they can eat peaches depends on their individual disease state. If a patient does not have increased creatinine levels and no edema, they can eat peaches like a normal person without any restrictions on quantity. If the patient has increased creatinine levels, they need to control the amount of peaches they consume. This is because, in patients with elevated creatinine, the glomerular filtration rate is decreased, and a decrease in glomerular filtration rate can lead to an inability to expel excess potassium ions from the body. Peaches are a fruit with a high potassium content, and if such patients consume too many peaches, it can lead to hyperkalemia. Mild cases may experience weakness and numbness in the limbs, while severe cases can lead to potentially fatal cardiac arrhythmias.

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Written by Li Liu Sheng
Nephrology
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How to control IgA nephropathy?

IgA nephropathy is a very common type of glomerular disease in clinical practice and is also a major cause of uremia. Therefore, sufficient attention should be given to IgA nephropathy by patients, and active treatment is required. The treatment of IgA nephropathy usually depends on the clinical manifestations and pathological types of the patient, meaning that the treatment approaches for patients with different clinical manifestations of IgA nephropathy are not exactly the same. For patients who frequently experience gross hematuria, if it is related to tonsil infection, it is recommended that the patient undergo tonsillectomy. For patients with IgA nephropathy who only have microscopic hematuria, there is generally no need for special medication treatment. However, in daily life, regular monitoring of routine urine tests, kidney function, and blood pressure is necessary, and the use of drugs that are toxic to the kidneys should be avoided. For patients with IgA nephropathy who also have significant proteinuria, even nephrotic syndrome, treatment often requires the use of steroids, and even immunosuppressants. For patients with mild to moderate proteinuria, it is recommended to use angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Only in this way can the condition of IgA nephropathy be controlled.

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Written by Zhou Qi
Nephrology
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Can IgA nephropathy be cured?

IgA nephropathy cannot be completely cured. IgA nephropathy is a type of chronic glomerulonephritis and is a chronic disease. Currently, it is incurable in medical practice. However, many patients have only mild symptoms, such as mild hematuria, proteinuria, and minor kidney damage, and timely long-term management of the disease usually does not lead to severe consequences. Some patients, on the other hand, have relatively severe conditions and require treatment with steroid medications. Most of these patients can achieve relatively good treatment outcomes and ultimately avoid severe kidney failure. However, a very small number of patients may eventually experience significant proteinuria and even severe renal failure.

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Written by Hu Lin
Nephrology
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IgA kidney disease's etiology

IgA nephropathy can be divided into primary and secondary IgA nephropathy. Secondary IgA nephropathy includes, for example, lupus nephritis, allergic purpura nephritis, liver disease-related kidney damage, rheumatoid arthritis kidney damage, and so on. The etiology of primary IgA nephropathy is mainly due to the deposition of a type of immunoglobulin, IgA, in the mesangial area of the glomeruli, leading to a series of immune responses, which in turn cause inflammatory damage, resulting in a chronic glomerulonephritis. This form of IgA nephropathy is mainly related to mucosal immune defense, meaning it is linked to certain infectious factors. Additionally, some patients have high reactivity of their mucosa to certain food antigens, which leads to a series of immune-mediated inflammatory responses.

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Written by Zhou Qi
Nephrology
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The characteristics of proteinuria in IgA nephropathy

IgA nephropathy is a pathological type of chronic glomerulonephritis, which can cause patients to exhibit symptoms such as proteinuria and hematuria. Regarding the characteristics of proteinuria, it is generally primarily glomerular proteinuria. In the classification of patients' proteinuria, glomerular proteinuria accounts for a large proportion. If IgA nephropathy presents as chronic nephritis or nephrotic syndrome, the patient's level of proteinuria will be quite severe, with significant amounts of proteinuria, where the 24-hour urinary protein quantification may exceed 1g or even reach more than 3.5g. However, not all patients with IgA nephropathy have such high levels of proteinuria; some may only have mild proteinuria.

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Written by Zhou Qi
Nephrology
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Is IgA nephropathy sexually transmitted?

IgA nephropathy, a type of chronic glomerulonephritis, does not transmit through sexual intercourse. This condition involves a sterile inflammatory response within the glomeruli of the kidneys, not caused by pathogens such as bacteria, viruses, or fungi. Instead, it results from an immune dysfunction, causing inflammation in the glomeruli without any infectious agents. Therefore, IgA nephropathy is not contagious, and sexual intercourse does not pose a risk of transmitting the condition to a sexual partner. As such, patients with IgA nephropathy can engage in sexual activities if their physical condition permits.

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Written by Zhou Qi
Nephrology
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Can patients with IgA nephropathy have sexual intercourse?

Patients with IgA nephropathy can engage in sexual intercourse, but there are certain prerequisites. Firstly, this disease is not contagious, and it will not be transmitted to the partner during intercourse. Secondly, there is not a significant relationship between renal function and sexual capability; patients with kidney diseases typically retain normal sexual and reproductive functions. However, since sexual activity requires a certain amount of physical strength, and in cases where the patient's condition is particularly severe, it might render the patient unable to engage in sexual activities. Therefore, if the patient does not have significant hypertension, severe edema, especially genital edema, pulmonary edema, or heart failure, they would be capable of engaging in sexual activities, and thus can have intercourse.

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Written by Zhou Qi
Nephrology
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Why doesn't IgA nephropathy cause swelling?

IgA nephropathy refers to the abnormal deposition of IgA immunoglobulin in the glomeruli of patients, which causes an inflammatory response and damages the glomerular capillaries. The extent of this damage varies, so not all patients will experience swelling. If the condition is severe, causing significant proteinuria, patients may develop hypoproteinemia and consequent decrease in plasma colloidal osmotic pressure, leading to swelling. If renal failure has occurred, the kidneys' ability to excrete water decreases, which can also cause swelling. Some patients may experience swelling due to damage to the renal tubules, which increases the reabsorption capacity for water. Otherwise, patients may not show obvious swelling, such as those with only mild proteinuria and hematuria, whose clinical symptoms are not pronounced.