IgA nephropathy is a disease.

Written by Ji Kang
Nephrology
Updated on September 18, 2024
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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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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.

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Foods to Avoid with IgA Nephropathy

IgA nephropathy patients are a very common type of glomerular disease. For IgA nephropathy patients, it is crucial to adhere to a light diet, meaning they should avoid foods such as pickles, salted vegetables, kimchi, cured products, smoked products, and barbecues, focusing primarily on fresh vegetables and fruits. Of course, if IgA nephropathy patients also suffer from renal insufficiency, they must avoid various soy products including tofu, bean sprouts, soybean sprouts, mung bean sprouts, and nut-based foods. These foods contain a lot of plant proteins, which can increase the burden on the kidneys, leading to potential renal insufficiency. Additionally, they should not consume foods high in potassium, such as oranges, bananas, pineapples, etc. Therefore, it is essential for IgA nephropathy patients to be cautious with their diet.

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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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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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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.