The characteristics of proteinuria in IgA nephropathy

Written by Zhou Qi
Nephrology
Updated on September 06, 2024
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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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Written by Zhou Qi
Nephrology
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Why doesn't IgA nephropathy cause swelling?

IgA nephropathy refers to the abnormal deposition of IgA immunoglobulin in the glomeruli of patients, which causes an inflammatory response and damages the glomerular capillaries. The extent of this damage varies, so not all patients will experience swelling. If the condition is severe, causing significant proteinuria, patients may develop hypoproteinemia and consequent decrease in plasma colloidal osmotic pressure, leading to swelling. If renal failure has occurred, the kidneys' ability to excrete water decreases, which can also cause swelling. Some patients may experience swelling due to damage to the renal tubules, which increases the reabsorption capacity for water. Otherwise, patients may not show obvious swelling, such as those with only mild proteinuria and hematuria, whose clinical symptoms are not pronounced.

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Written by Zhou Qi
Nephrology
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Causes of hematuria in IgA nephropathy

IGA nephropathy is a type of chronic glomerulonephritis. This disease often causes patients to have blood in their urine, and can also lead to visible blood in the urine. The glomerulus is a cluster of capillaries with semi-permeable functions, allowing water and metabolic waste to pass through while preventing proteins and red blood cells from passing. The waste and water pass through the glomerular filtration barrier and enter into the urine, which is the main component of urine. If some pathological cause damages the capillaries of the glomerulus, such as in the case of IGA nephropathy where there is an inflammatory response within the glomerulus, it can damage the glomerular filtration barrier. As a result, red blood cells may pass through the capillary walls of the glomerulus into the urine, causing blood in the urine.

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Written by Zhou Qi
Nephrology
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Can patients with IgA nephropathy have sexual intercourse?

Patients with IgA nephropathy can engage in sexual intercourse, but there are certain prerequisites. Firstly, this disease is not contagious, and it will not be transmitted to the partner during intercourse. Secondly, there is not a significant relationship between renal function and sexual capability; patients with kidney diseases typically retain normal sexual and reproductive functions. However, since sexual activity requires a certain amount of physical strength, and in cases where the patient's condition is particularly severe, it might render the patient unable to engage in sexual activities. Therefore, if the patient does not have significant hypertension, severe edema, especially genital edema, pulmonary edema, or heart failure, they would be capable of engaging in sexual activities, and thus can have intercourse.

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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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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.