How to treat occult blood in IgA nephropathy

Written by Zhou Qi
Nephrology
Updated on September 28, 2024
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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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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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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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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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What will happen if someone with IgA nephropathy stays up late?

IgA nephropathy is a very common glomerular disease in clinical settings and is one of the main causes of uremia. IgA nephropathy is most commonly seen in adolescents, particularly in males. The cause of IgA nephropathy is currently unclear, but the clinical manifestations of patients with IgA nephropathy are numerous and vary in severity. For patients with milder IgA nephropathy, it is important to maintain a healthy lifestyle, avoid staying up late, overworking, and infections. Frequently staying up late can aggravate the condition, leading to significant proteinuria and even worsening kidney function. Therefore, it is crucial for patients with IgA nephropathy to regularly monitor their urinalysis, kidney function, and blood pressure, maintain a regular lifestyle, and avoid various adverse lifestyle impacts. Of course, once the condition worsens, it is important to seek medical attention promptly and pursue active treatment.

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IgA nephropathy stages 1, 2, 3 criteria

According to the standards of the World Health Organization, IgA nephropathy is classified into five stages pathologically. The first stage is where most glomeruli appear normal under light microscopy, with only minor mesangial proliferation or associated cellular proliferation, generally showing slight changes without damage to the tubules and interstitium; The second stage indicates mild lesions where over fifty percent of the glomeruli are normal, with only a small portion of the glomeruli showing mesangial cell proliferation, glomerular sclerosis adhesion, and other changes, without the formation of crescents; The third stage is focal segmental glomerulonephritis, characterized by diffuse proliferation of mesangial cells and widening of the mesangial areas, with the lesions exhibiting focal segmental changes and comparatively mild interstitial lesions.