IgA kidney disease's etiology

Written by Hu Lin
Nephrology
Updated on September 07, 2024
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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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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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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.

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IgA kidney disease symptoms

IgA nephropathy is characterized by the deposition of IgA in the glomerular mesangial regions and is a common type of glomerulonephritis. It is also a major cause of uremia. IgA nephropathy typically affects adolescents. Once diagnosed, patients primarily experience recurrent macroscopic hematuria, especially after skin infections or respiratory infections, during which blood in the urine becomes more apparent. Of course, there can also be asymptomatic hematuria and increased urinary protein. Some patients with IgA nephropathy may also experience edema, particularly in the eyelids and facial area upon waking up in the morning, and in severe cases, there may be an increase in blood pressure and a decline in kidney function. It is essential for patients with IgA nephropathy to have regular follow-ups to monitor changes in routine urine tests, kidney function, and blood pressure, and to seek active treatment if the condition worsens.

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Can patients with IgA nephropathy eat beef?

Diet plays a very important role in the treatment of IgA nephropathy patients. For IgA nephropathy patients, the general dietary requirement is to eat a light diet, avoid spicy foods, and avoid fried foods. IgA nephropathy patients can eat beef. Beef contains animal protein, which is a high-quality protein with essential amino acids that are easily absorbed and utilized by the human body. Of course, if IgA nephropathy patients have normal kidney function, there aren't too many restrictions on their diet compared to healthy individuals. They should mainly consume fresh vegetables and fruits, and avoid pickles, salty vegetables, and fermented vegetables. If there is accompanying kidney dysfunction, it is advisable to minimize the intake of plant proteins and limit the consumption of plant-based proteins such as soy products.

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How is IgA nephropathy caused?

IgA nephropathy is a common glomerular disease and a major cause of uremia. However, the exact cause of IgA nephropathy is not very clear. Current research suggests that it is caused by factors such as infections which stimulate the production of autoantibodies, forming immune complexes that deposit in the glomeruli. This leads to inflammation of the glomeruli, eventually stimulating mesangial cell proliferation and accumulation of extracellular matrix, causing glomerulosclerosis and interstitial fibrosis. IgA nephropathy is a very covert disease, often presenting as asymptomatic hematuria or increased urine protein. Many patients discover this condition incidentally during physical examinations. Some individuals have a history of upper respiratory or gastrointestinal infections before the onset of the disease, followed by the discovery of gross hematuria. IgA nephropathy is more common in children and adolescents.