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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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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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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How to maintain health with IgA nephropathy normally?

This is a pathological type of chronic glomerulonephritis, which is a diagnostic term in immunopathology and essentially represents chronic glomerulonephritis. The severity of this disease can vary, as can its clinical manifestations. Patients should avoid catching colds in their daily life by staying warm and not seeking cool environments. It is important to maintain a distance from people who are already sick to avoid close contact. In terms of diet, patients should eat low-salt, low-fat, and high-quality low-protein foods, and control their salt intake, but not completely avoid salt. Also, they should avoid eating too much greasy and fatty food.

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Written by Zhou Qi
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Can IgA nephropathy stage 2 be cured?

IgA nephropathy is an immunopathological diagnostic term for chronic glomerulonephritis, indicating that the patient has chronic nephritis. In fact, chronic nephritis does not have a concept of complete cure. Stage two patients indicate that the inflammatory reaction within the glomerulus is not very severe, but the patient may also show more proteinuria. In most cases, the renal function of these patients is still normal, and it may be necessary to decide whether to choose medications such as corticosteroids based on the amount of proteinuria. If the patient responds well to medication, the proteinuria may significantly decrease, or even turn negative, but it cannot be completely cured, as this is a chronic disease, and there is also a possibility of relapse in the later stages of the disease. (Please follow the doctor's orders regarding medication use.)

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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.)