How to treat IgA nephropathy?

Written by Li Liu Sheng
Nephrology
Updated on February 11, 2025
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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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How to treat occult blood in IgA nephropathy

IGA disease is a pathological type of chronic glomerulonephritis. This type of glomerular lesion often leads to positive occult blood in urine, and in some cases, may even cause gross hematuria visible to the naked eye. However, the relationship between hematuria and the severity or prognosis of the patient's condition is not very clear, so clinically, hematuria is not considered as a treatment target. Generally, during the active phase of the disease, patients can be treated with corticosteroids and other medications, especially those with more than 1g of protein in a 24-hour urine collection. Otherwise, most patients choose ACE inhibitors or ARBs as antihypertensive drugs to reduce the pressure inside the glomerulus. Additionally, avoiding colds can also help reduce occult blood in urine. (Specific medications should be administered under the guidance of a physician)

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Written by Zhou Qi
Nephrology
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Can IgA nephropathy patients eat watermelon?

IgA nephropathy is a chronic glomerulonephritis with varying degrees of severity and diverse clinical manifestations. Whether patients can eat watermelon depends on their kidney function and the presence of edema symptoms. If patients have kidney failure and noticeable edema, it is advised that they avoid eating watermelon, as it contains a significant amount of potassium ions. Consuming watermelon may lead to hyperkalemia due to the intake of large amounts of potassium ions. The main component of watermelon is water, and if patients have noticeable symptoms of edema, eating watermelon may exacerbate these symptoms and even cause issues like hypertension. If patients do not have noticeable edema and their kidney function is normal, eating small amounts of watermelon should not be a major concern.

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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 Hu Lin
Nephrology
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IgA kidney disease symptoms

The clinical manifestations of IgA nephropathy are diverse. The most common clinical manifestations include episodic gross hematuria, asymptomatic hematuria, and proteinuria. Episodic gross hematuria often occurs several hours after an upper respiratory tract infection, or a day or two later. Patients may notice that their urine is dark tea-colored, brown, or fresh red, light red, and this type of gross hematuria tends to recur. The second type is asymptomatic microscopic hematuria, with or without proteinuria, also known as asymptomatic urinalysis. This is often discovered during physical examinations when patients show no symptoms and tests reveal hidden blood and protein positivity in the urine. The third major category is proteinuria, which in some patients may present as nephrotic syndrome-like proteinuria. The fourth is hypertension; the fifth, acute kidney injury; and the sixth, chronic kidney failure. Most patients with IgA nephropathy gradually progress to chronic kidney failure within 10 to 20 years of diagnosis.

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Written by Li Liu Sheng
Nephrology
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Does stage 2 IgA nephropathy require treatment?

IgA nephropathy can be divided into five stages, where stages one to two are relatively mild, early stages, and generally have a good prognosis. For patients with stage two IgA nephropathy, it is rare for the condition to progress to uremia, but whether treatment is needed largely depends on the clinical manifestations of the IgA nephropathy. If a patient with IgA nephropathy has a 24-hour urinary protein quantification greater than 0.5g, it is advisable to use an angiotensin-converting enzyme inhibitor or an angiotensin II receptor antagonist to protect kidney function and reduce urinary protein. If a stage two IgA nephropathy patient only shows microscopic hematuria, drug treatment is not necessary. However, routine urinalysis and kidney function monitoring should be conducted in daily life, and if an infection occurs, timely anti-infection treatment should be administered. If a stage two IgA nephropathy patient has significant proteinuria, steroid treatment is often required. (Medication should be taken under the guidance of a doctor.)