How Different Are the Current Understandings of Treatments for IgA Nephropathy?

Published on 02/05/2016 by admin

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Last modified 03/05/2016

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Fig. 8.1

Answers selected by the audience for Case 1
  • In January 2014, BP 124/68, proteinuria 1.5 g/day, urinary RBC 5-9/HPF, eGFR 55 mL/min/1.73 m2. Renal biopsy: acute lesion (endocapillary hypercellularity) (+), chronic lesion (+). In May 2014, BP 124/68, proteinuria 1.5 g/day, urinary RBC 5-9/HPF, eGFR 55 mL/min/1.73 m2.
Case 2
48-year-old female with no medication (see Fig. 8.2 for the questionnaire result)

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Fig. 8.2

Answers selected by the audience for Case 2
  • In November 2013, BP 128/78, proteinuria 1.8 g/day, urinary RBC11-20 /HPF, eGFR 100 mL/min/1.73 m2. Renal biopsy: acute lesion (endocapillary hypercellularity) (+). After 6 months of medication with ACEI, in May 2014, BP 118/70, proteinuria 1.2 g/day, urinary RBC 11-20/HPF, eGFR 100 mL/min/1.73 m2.
References
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Berger J, Hinglais N. Intercapillary deposits of IgA-IgG. J Urol Nephrol. 1968;74:694–5.
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Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013;368:2402–14.CrossRefPubMed
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Berthoux F, Mohey H, Laurent B, Mariat C, Afiani A, Thibaudin L. Predicting the risk for dialysis or death in IgA nephropathy. J Am Soc Nephrol. 2011;22:752–61.CrossRefPubMedPubMedCentral
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D’Amico G. Natural history of idiopathic IgA nephropathy: role of clinical and histological prognostic factors. Am J Kidney Dis. 2000;36:227–37.CrossRefPubMed
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Suzuki H, Kiryluk K, Novak J, Moldoveanu Z, Herr AB, Renfrow MB, et al. The pathophysiology of IgA nephropathy. J Am Soc Nephrol. 2011;22:1795–803. doi:10.​1681/​ASN.​2011050464.CrossRefPubMedPubMedCentral
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Reich HN, Troyanov S, Scholey JW, Cattran DC, for the Toronto Glomerulonephritis Registry. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18:3177–83.CrossRefPubMed
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Radhakrishnan J, Cattran DC. The KDIGO practice guideline on glomerulonephritis: reading between the (guide)lines—application to the individual patient. Kidney Int. 2012;82:840–56. doi:10.​1038/​ki.​2012.​280.CrossRefPubMed
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Appel GB, Waldman M. The IgA nephropathy treatment dilemma. Kidney Int. 2006;69:1939–44.CrossRefPubMed
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Barratt J, Feehally J. Treatment of IgA nephropathy. Kidney Int. 2006;69:1934–8.CrossRefPubMed
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Reich HN, Troyanov S, Scholey JW, Cattran DC, Toronto Glomerulonephritis Registry. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18:3177–83.CrossRefPubMed
11.
Dillon JJ. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for IgA nephropathy. Semin Nephrol. 2004;24:218–24.CrossRef

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