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

Published on 02/05/2016 by admin

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Last modified 22/04/2025

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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
1.
Berger J, Hinglais N. Intercapillary deposits of IgA-IgG. J Urol Nephrol. 1968;74:694–5.
2.
Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013;368:2402–14.CrossRefPubMed
3.
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
4.
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
5.
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
6.
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
7.
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
8.
Appel GB, Waldman M. The IgA nephropathy treatment dilemma. Kidney Int. 2006;69:1939–44.CrossRefPubMed
9.
Barratt J, Feehally J. Treatment of IgA nephropathy. Kidney Int. 2006;69:1934–8.CrossRefPubMed
10.
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.CrossRefPubMed
12.
Praga M, Gutiérrez E, González E, Morales E, Hernández E. Treatment of IgA nephropathy with ACE inhibitors: a randomized and controlled trial. J Am Soc Nephrol. 2003;14:1578–83.CrossRefPubMed
13.
Coppo R, Peruzzi L, Amore A, Piccoli A, Cochat P, Stone R, et al. IgACE: a placebo-controlled, randomized trial of angiotensin-converting enzyme inhibitors in children and young people with IgA nephropathy and moderate proteinuria. J Am Soc Nephrol. 2007;18:1880–8.CrossRefPubMed
14.
Li PK, Leung CB, Chow KM, Cheng YL, Fung SK, Mak SK, HKVIN Study Group, et al. Hong Kong study using valsartan in IgA nephropathy (HKVIN): a double-blind, randomized, placebo-controlled study. Am J Kidney Dis. 2006;47:751–60.CrossRefPubMed
15.
Donadio Jr JV. Omega-3 polyunsaturated fatty acids: a potential new treatment of immune renal disease. Mayo Clin Proc. 1991;66:1018–28.CrossRefPubMed
16.
Donadio Jr JV, Bergstralh EJ, Offord KP, Spencer DC, Holley KE, for The Mayo Nephrology Collaborative Group. A controlled trial of fish oil in IgA nephropathy. N Engl J Med. 1994;331:1194–9.CrossRefPubMed
17.
Yagame M, Tomino Y, Miura M, Suga T, Endoh M, Nomoto Y, et al. Clinical effect of dipyridamole in patients with IgA nephropathy. Tokai J Exp Clin Med. 1986;11:329–33.PubMed
18.
Lee GS, Woo KT, Lim CH. Controlled trial of dipyridamole and low-dose warfarin in patients with IgA nephritis with renal impairment. Clin Nephrol. 1989;31:276.PubMed
19.
Reid S, Cawthon PM, Craig JC, Samuels JA, Molony DA, Strippoli GFM. Non-immunosuppressive treatment for IgA nephropathy. Cochrane Database Syst Rev. 2011. doi:10.​1002/​14651858.​CD003962.​pub2.
20.
Horita Y, Tadokoro M, Taura K, Ashida R, Hiu M, Taguchi T, et al. Prednisolone co-administered with losartan confers renoprotection in patients with IgA nephropathy. Ren Fail. 2007;29:441–6.CrossRefPubMedPubMedCentral
21.
Mustonen J, Pasternack A, Rantala I. The nephrotic syndrome in IgA glomerulonephritis: response to corticosteroid therapy. Clin Nephrol. 1983;20:172–6.PubMed
22.
Kobayashi Y, Fujii K, Hiki Y, Tateno S. Steroid therapy in IgA nephropathy: a prospective pilot study in moderate proteinuric cases. Q J Med. 1986;61:935–43.PubMed
23.
Pozzi C, Bolasco PG, Fogazzi GB, Andrulli S, Altieri P, Ponticelli C, et al. Corticosteroids in IgA nephropathy: a randomised controlled trial. Lancet. 1999;353:883–7.CrossRefPubMed
24.
Pozzi C, Andrulli S, Del Vecchio L, Melis P, Fogazzi GB, Altieri P, et al. Corticosteroid effectiveness in IgA nephropathy: long-term results of a randomized, controlled trial. J Am Soc Nephrol. 2004;15:157–63.CrossRefPubMed
25.
Katafuchi R, Ikeda K, Mizumasa T, Tanaka H, Ando T, Yanase T, et al. Controlled, prospective trial of steroid treatment in IgA nephropathy: a limitation of low-dose prednisolone therapy. Am J Kidney Dis. 2003;41:972–83.CrossRefPubMed
26.
Samuels JA, Strippoli GFM, Craig JC, Schena FP, Molony DA. Immunosuppressive agents for treating IgA nephropathy. Cochrane Database Syst Rev. 2003;4:CD003965.
27.
Henderson L, Masson P, Craig JC, Flanc RS, Roberts MA, Strippoli GF, et al. Treatment for lupus nephritis. Cochrane Database Syst Rev. 2012;12:CD002922.PubMed
28.
Maes BD, Oyen R, Claes K, Evenepoel P, Kuypers D, Vanwalleghem J, et al. Mycophenolate mofetil in IgA nephropathy: results of a 3-year prospective placebo-controlled randomized study. Kidney Int. 2004;65:1842–9.CrossRefPubMed
29.
Frisch G, Lin J, Rosenstock J, Markowitz G, D’Agati V, Radhakrishnan J, et al. Remission of proteinuria improves prognosis in IgA nephropathy. Nephrol Dial Transplant. 2005;20:2139–45.CrossRefPubMed
30.
Tang SCW, Tang AWC, Wong SSH, Leung JCK, Ho YW, Lai KN. Long-term study of mycophenolate mofetil treatment in IgA nephropathy. Kidney Int. 2010;77:543–9.CrossRefPubMed
31.
Tan CH, Loh PT, Yang WS, Chan CM. Mycophenolate mofetil in the treatment of IgA nephropathy: a systematic review. Singapore Med J. 2008;49:780–5.PubMed
32.
Xu G, Tu W, Jiang D, Xu C. Mycophenolate mofetil treatment for IgA nephropathy: a meta-analysis. Am J Nephrol. 2009;29:362–7.CrossRefPubMed
33.
Hotta O, Miyazaki M, Furuta T, Tomioka S, Chiba S, Horigome I, et al. Remission of proteinuria improves prognosis in IgA nephropathy. Am J Kidney Dis. 2001;38:736–43.CrossRefPubMed
34.
Miura N, Imai H, Kikuchi S, Hayashi S, Endoh M, Kawamura T, et al. Tonsillectomy and steroid pulse (TSP) therapy for patients with IgA nephropathy: a nationwide survey of TSP therapy in Japan and an analysis of the predictive factors for resistance to TSP therapy. Clin Exp Nephrol. 2009;13:460–6. doi:10.​1007/​s10157-009-0179-1.CrossRefPubMed
35.
Xie Y, Chen X, Nishi S, Narita I, Gejyo F. Relationship between tonsils and IgA nephropathy as well as indications of tonsillectomy. Kidney Int. 2004;65:1135–44.CrossRefPubMed
36.
Chen Y, Tang Z, Wang Q, Yu Y, Zeng C, Chen H, et al. Long-term efficacy of tonsillectomy in Chinese patients with IgA nephropathy. Am J Nephrol. 2007;27:170–5.CrossRefPubMed
37.
Rasche FM, Schwarz A, Keller F. Tonsillectomy does not prevent a progressive course in IgA nephropathy. Clin Nephrol. 1999;51:147–52.PubMed
38.
Sato M, Hotta O, Tomioka S, Horigome I, Chiba S, Miyazaki M, et al. Cohort study of advanced IgA nephropathy: efficacy and limitations of corticosteroids with tonsillectomy. Nephron Clin Pract. 2003;93:137–45.CrossRef
39.
Kawamura T, Yoshimura M, Miyazaki Y, Okamoto H, Kimura K, Hirano K, Special IgA Nephropathy Study Group, et al. A multicenter randomized controlled trial of tonsillectomy combined with steroid pulse therapy in patients with immunoglobulin A nephropathy. Nephrol Dial Transplant. 2014;29:1546–53. doi:10.​1093/​ndt/​gfu020.CrossRefPubMedPubMedCentral