How to control IgA nephropathy?

Written by Li Liu Sheng
Nephrology
Updated on September 11, 2024
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IgA nephropathy is a very common type of glomerular disease in clinical practice and is also a major cause of uremia. Therefore, sufficient attention should be given to IgA nephropathy by patients, and active treatment is required. The treatment of IgA nephropathy usually depends on the clinical manifestations and pathological types of the patient, meaning that the treatment approaches for patients with different clinical manifestations of IgA nephropathy are not exactly the same. For patients who frequently experience gross hematuria, if it is related to tonsil infection, it is recommended that the patient undergo tonsillectomy. For patients with IgA nephropathy who only have microscopic hematuria, there is generally no need for special medication treatment. However, in daily life, regular monitoring of routine urine tests, kidney function, and blood pressure is necessary, and the use of drugs that are toxic to the kidneys should be avoided. For patients with IgA nephropathy who also have significant proteinuria, even nephrotic syndrome, treatment often requires the use of steroids, and even immunosuppressants. For patients with mild to moderate proteinuria, it is recommended to use angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Only in this way can the condition of IgA nephropathy be controlled.

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Written by Zhou Qi
Nephrology
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IgA nephropathy manifestations

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 Li Liu Sheng
Nephrology
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How to treat IgA nephropathy?

IgA nephropathy has many clinical manifestations and pathological types, and the treatment of IgA nephropathy is selected based on different clinical manifestations and pathological types. Usually, for patients with IgA nephropathy who only show microscopic hematuria, drug treatment is not necessary. They only need to regularly monitor routine urine tests, kidney function, and blood pressure changes in daily life, and must avoid using medications that are toxic to the kidneys. If the patient presents with gross hematuria related to tonsillar infection, tonsillectomy is recommended. If an IgA nephropathy patient has increased urinary protein, and the 24-hour urinary protein quantification exceeds 1g, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers can be used. Of course, for patients with significant proteinuria, steroids or immunosuppressants may also be used. In addition, IgA nephropathy patients can also be treated with traditional Chinese medicine. (Medication use should be under the guidance of a professional doctor.)

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Written by Zhou Qi
Nephrology
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How is IgA nephropathy diagnosed?

The diagnosis of IgA nephropathy relies on pathological examination. The name "IgA nephropathy" itself is a term used in immunopathological diagnosis, describing a type of chronic glomerulonephritis. There are many reasons that can cause inflammatory reactions in the kidneys, and the underlying mechanisms of the disease vary. Specifically, IgA nephropathy refers to the abnormal deposition of IgA immune complexes in the mesangial areas of the glomeruli. Therefore, a pathological examination is necessary for diagnosis. Typically, under a light microscope, proliferation of mesangial cells and widening of the mesangial areas can be observed. Additionally, immunofluorescence testing is conducted to detect a large presence of IgA immune complexes in the glomerular mesangial areas, confirming the diagnosis of IgA nephropathy.

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Written by Li Liu Sheng
Nephrology
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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.

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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.