Does stage 2 IgA nephropathy require treatment?

Written by Li Liu Sheng
Nephrology
Updated on January 17, 2025
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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.)

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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 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 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.)

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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.)