IgA nephropathy
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In medicine, IgA nephropathy, also called Berger's Disease, is a "chronic form of glomerulonephritis characterized by deposits of predominantly immunoglobulin A in the mesangial area (glomerular mesangium). Deposits of complement C3 and immunoglobulin G are also often found. Clinical features may progress from asymptomatic hematuria to end-stage kidney disease."[1]
Treatment
Treatment options include:
- Inhibitors of the renin angiotensin system according to a meta-analysis[2][3] of randomized controlled trials.[4]
- Corticosteroids according to a meta-analysis of randomized controlled trials.[5][6]
- Adding azathioprine to corticosteroids may[7][8] or may not help[9].
- Platelet aggregation inhibitors and other anti-hemostatic agents according to meta-analyses[10][11]
- Omega-3 fatty acids (fish oil) may help.[12]
- Oral calcitriol according to a single randomized controlled trial.[13]
Treatments that have been studied but do not clearly help include:
References
- ↑ Anonymous (2023), IgA nephropathy (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Reid S, Cawthon PM, Craig JC, Samuels JA, Molony DA, Strippoli GF (2011). "Non-immunosuppressive treatment for IgA nephropathy.". Cochrane Database Syst Rev (3): CD003962. DOI:10.1002/14651858.CD003962.pub2. PMID 21412884. Research Blogging.
- ↑ Cheng J, Zhang W, Zhang XH, He Q, Tao XJ, Chen JH (2009). "ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials.". Int J Clin Pract 63 (6): 880-8. DOI:10.1111/j.1742-1241.2009.02038.x. PMID 19490198. Research Blogging.
- ↑ Manno C, Torres DD, Rossini M, Pesce F, Schena FP (2009). "Randomized controlled clinical trial of corticosteroids plus ACE-inhibitors with long-term follow-up in proteinuric IgA nephropathy.". Nephrol Dial Transplant 24 (12): 3694-701. DOI:10.1093/ndt/gfp356. PMID 19628647. Research Blogging.
- ↑ Zhou YH, Tang LG, Guo SL, Jin ZC, Wu MJ, Zang JJ et al. (2011). "Steroids in the treatment of IgA nephropathy to the improvement of renal survival: a systematic review and meta-analysis.". PLoS One 6 (4): e18788. DOI:10.1371/journal.pone.0018788. PMID 21533280. PMC PMC3075273. Research Blogging.
- ↑ Pozzi C, Bolasco PG, Fogazzi GB, Andrulli S, Altieri P, Ponticelli C et al. (1999). "Corticosteroids in IgA nephropathy: a randomised controlled trial.". Lancet 353 (9156): 883-7. PMID 10093981. [e]
- ↑ Kamei K, Nakanishi K, Ito S, Saito M, Sako M, Ishikura K et al. (2011). "Long-term results of a randomized controlled trial in childhood IgA nephropathy.". Clin J Am Soc Nephrol 6 (6): 1301-7. DOI:10.2215/CJN.08630910. PMID 21493743. PMC PMC3109925. Research Blogging.
- ↑ Stangou M, Ekonomidou D, Giamalis P, Liakou H, Tsiantoulas A, Pantzaki A et al. (2011). "Steroids and azathioprine in the treatment of IgA nephropathy.". Clin Exp Nephrol 15 (3): 373-80. DOI:10.1007/s10157-011-0415-3. PMID 21301920. Research Blogging.
- ↑ Pozzi C, Andrulli S, Pani A, Scaini P, Del Vecchio L, Fogazzi G et al. (2010). "Addition of azathioprine to corticosteroids does not benefit patients with IgA nephropathy.". J Am Soc Nephrol 21 (10): 1783-90. DOI:10.1681/ASN.2010010117. PMID 20634300. PMC PMC3013548. Research Blogging.
- ↑ Taji Y, Kuwahara T, Shikata S, Morimoto T (2006). "Meta-analysis of antiplatelet therapy for IgA nephropathy.". Clin Exp Nephrol 10 (4): 268-73. DOI:10.1007/s10157-006-0433-8. PMID 17186331. Research Blogging.
- ↑ Liu XJ, Geng YQ, Xin SN, Huang GM, Tu XW, Ding ZR et al. (2011). "Antithrombotic drug therapy for IgA nephropathy: a meta analysis of randomized controlled trials.". Intern Med 50 (21): 2503-10. PMID 22041349. [e]
- ↑ Donadio JV, Bergstralh EJ, Offord KP, Spencer DC, Holley KE (1994). "A controlled trial of fish oil in IgA nephropathy. Mayo Nephrology Collaborative Group.". N Engl J Med 331 (18): 1194-9. DOI:10.1056/NEJM199411033311804. PMID 7935657. Research Blogging.
- ↑ Liu LJ, Lv JC, Shi SF, Chen YQ, Zhang H, Wang HY (2012). "Oral calcitriol for reduction of proteinuria in patients with IgA nephropathy: a randomized controlled trial.". Am J Kidney Dis 59 (1): 67-74. DOI:10.1053/j.ajkd.2011.09.014. PMID 22019331. Research Blogging.
- ↑ Liu XW, Li DM, Xu GS, Sun SR (2010). "Comparison of the therapeutic effects of leflunomide and mycophenolate mofetil in the treatment of immunoglobulin A nephropathy manifesting with nephrotic syndrome.". Int J Clin Pharmacol Ther 48 (8): 509-13. PMID 20650041. [e]
- ↑ Xu G, Tu W, Jiang D, Xu C (2009). "Mycophenolate mofetil treatment for IgA nephropathy: a meta-analysis.". Am J Nephrol 29 (5): 362-7. DOI:10.1159/000168483. PMID 18974636. Research Blogging.