How to control IgA nephropathy?

Written by Li Liu Sheng
Nephrology
Updated on September 11, 2024
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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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How is IgA nephropathy diagnosed?

The diagnosis of IgA nephropathy relies on pathological examination. The name "IgA nephropathy" itself is a term used in immunopathological diagnosis, describing a type of chronic glomerulonephritis. There are many reasons that can cause inflammatory reactions in the kidneys, and the underlying mechanisms of the disease vary. Specifically, IgA nephropathy refers to the abnormal deposition of IgA immune complexes in the mesangial areas of the glomeruli. Therefore, a pathological examination is necessary for diagnosis. Typically, under a light microscope, proliferation of mesangial cells and widening of the mesangial areas can be observed. Additionally, immunofluorescence testing is conducted to detect a large presence of IgA immune complexes in the glomerular mesangial areas, confirming the diagnosis of IgA nephropathy.

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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 Li Liu Sheng
Nephrology
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How to treat IgA nephropathy?

IgA nephropathy has many clinical manifestations and pathological types, and the treatment of IgA nephropathy is selected based on different clinical manifestations and pathological types. Usually, for patients with IgA nephropathy who only show microscopic hematuria, drug treatment is not necessary. They only need to regularly monitor routine urine tests, kidney function, and blood pressure changes in daily life, and must avoid using medications that are toxic to the kidneys. If the patient presents with gross hematuria related to tonsillar infection, tonsillectomy is recommended. If an IgA nephropathy patient has increased urinary protein, and the 24-hour urinary protein quantification exceeds 1g, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers can be used. Of course, for patients with significant proteinuria, steroids or immunosuppressants may also be used. In addition, IgA nephropathy patients can also be treated with traditional Chinese medicine. (Medication use should be under the guidance of a professional doctor.)

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Written by Zhou Qi
Nephrology
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Kidney disease IgA means IgA nephropathy.

Kidney disease IgA, formally known as IgA nephropathy, is an immunological diagnostic term for chronic glomerulonephritis. It is characterized by the deposition of immune complexes, primarily IgA, in the mesangial areas of the glomeruli. IgA is a type of immunoglobulin, which upon deposition in the kidneys induces inflammatory responses, leading to proliferation of mesangial cells, accumulation of mesangial matrix, and widening of the mesangial area. This can cause damage to the glomerular filtration barrier, manifesting as proteinuria and hematuria. Some patients may also develop crescent formations in the glomeruli, leading to renal failure.

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Written by Li Liu Sheng
Nephrology
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Is IgA nephropathy grade 3 serious?

IgA nephropathy is divided into five stages pathologically, with stage three being the focal proliferative type. The higher the stage, the more severe the condition of IgA nephropathy. Stage three is in the early to middle phase, where generally the condition of the patients is comparatively good, and rarely worsens to uremia, belonging to the low-risk group. Clinically, patients with stage three IgA nephropathy often exhibit repeated occurrences of gross hematuria or persistent microscopic hematuria. Some patients may also experience varying degrees of increased urinary protein. Patients with this stage of IgA nephropathy rarely suffer from hypertension or renal insufficiency, but it is essential in daily life to avoid nephrotoxic drugs, prevent infections, seek medical attention promptly upon infection, and regularly follow up on routine urine and renal function changes. If the condition tends to worsen, active treatment should be pursued.