IgA nephropathy manifestations

Written by Zhou Qi
Nephrology
Updated on September 24, 2024
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IgA nephropathy is a pathological type of chronic glomerulonephritis. The clinical manifestations of this disease are diverse, with the typical clinical presentation of IgA nephropathy being hematuria, especially visible hematuria following a cold.

However, patients may also exhibit other features, such as significant amounts of urinary protein. In some cases, this can reach the level of 3.5g in a 24-hour urine protein quantification. Patients may experience edema, such as swelling in the lower limbs, eyelids, etc. There could also be clinical presentations of high blood pressure, rapid progression of renal failure, and other symptoms.

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Written by Ji Kang
Nephrology
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How to determine the stages of IgA nephropathy?

IGA nephropathy has different grading methods, such as Lee grading and Hass grading. Both classify the pathological changes of IGA nephropathy into five stages, with similar descriptions. According to the Lee grading: Grade 1: Most glomeruli are normal, with occasional mild mesangial widening or without cellular proliferation, and no tubulointerstitial changes. Grade 2: Glomeruli show focal mesangial proliferation, with no tubulointerstitial changes. Grade 3: Glomeruli exhibit diffuse mesangial proliferation, with occasional segmental focal lesions, rare crescents, and adhesions, focal interstitial edema, and rare cellular infiltration. Grade 4: Glomeruli show diffuse severe mesangial proliferation and sclerosis, partial or segmental glomerulosclerosis, crescent formation observed but less than 45%, tubular atrophy, interstitial infiltration. Grade 5: The nature of the lesions is similar to grade 4 but more severe. Crescent formation in glomeruli is greater than 45%.

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Written by Zhou Qi
Nephrology
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Is IgA nephropathy sexually transmitted?

IgA nephropathy, a type of chronic glomerulonephritis, does not transmit through sexual intercourse. This condition involves a sterile inflammatory response within the glomeruli of the kidneys, not caused by pathogens such as bacteria, viruses, or fungi. Instead, it results from an immune dysfunction, causing inflammation in the glomeruli without any infectious agents. Therefore, IgA nephropathy is not contagious, and sexual intercourse does not pose a risk of transmitting the condition to a sexual partner. As such, patients with IgA nephropathy can engage in sexual activities if their physical condition permits.

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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 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 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.