IgA nephropathy: Difference between revisions

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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 (immunologic)|complement]] C3 and [[immunoglobulin]] G are also often found. Clinical features may progress from asymptomatic [[hematuria]] to [[end-stage kidney disease]]."<ref>{{MeSH}}</ref>
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 (immunologic)|complement]] C3 and [[immunoglobulin]] G are also often found. Clinical features may progress from asymptomatic [[hematuria]] to [[end-stage kidney disease]]."<ref>{{MeSH}}</ref>


==Treatment==
==Treatment==
Treatment options include:
Treatment options include:
* Inhibitors of the [[renin angiotensin system]] according to a [[meta-analysis]] of [[randomized controlled trial]]s.<ref name="pmid21412884">{{cite journal| author=Reid S, Cawthon PM, Craig JC, Samuels JA, Molony DA, Strippoli GF| title=Non-immunosuppressive treatment for IgA nephropathy. | journal=Cochrane Database Syst Rev | year= 2011 | volume=  | issue= 3 | pages= CD003962 | pmid=21412884 | doi=10.1002/14651858.CD003962.pub2 | pmc= | url= }} </ref>
* Inhibitors of the [[renin angiotensin system]] according to a [[meta-analysis]]<ref name="pmid21412884">{{cite journal| author=Reid S, Cawthon PM, Craig JC, Samuels JA, Molony DA, Strippoli GF| title=Non-immunosuppressive treatment for IgA nephropathy. | journal=Cochrane Database Syst Rev | year= 2011 | volume=  | issue= 3 | pages= CD003962 | pmid=21412884 | doi=10.1002/14651858.CD003962.pub2 | pmc= | url= }} </ref><ref name="pmid19490198">{{cite journal| author=Cheng J, Zhang W, Zhang XH, He Q, Tao XJ, Chen JH| title=ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. | journal=Int J Clin Pract | year= 2009 | volume= 63 | issue= 6 | pages= 880-8 | pmid=19490198 | doi=10.1111/j.1742-1241.2009.02038.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19490198  }} </ref> of [[randomized controlled trial]]s.<ref name="pmid19628647">{{cite journal| author=Manno C, Torres DD, Rossini M, Pesce F, Schena FP| title=Randomized controlled clinical trial of corticosteroids plus ACE-inhibitors with long-term follow-up in proteinuric IgA nephropathy. | journal=Nephrol Dial Transplant | year= 2009 | volume= 24 | issue= 12 | pages= 3694-701 | pmid=19628647 | doi=10.1093/ndt/gfp356 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19628647  }} </ref>
* [[Corticosteroid]]s according to a [[meta-analysis]] of [[randomized controlled trial]]s.<ref  name="pmid21533280">{{cite journal| author=Zhou YH, Tang LG, Guo SL,  Jin ZC, Wu MJ, Zang JJ et al.| title=Steroids in the treatment of IgA  nephropathy to the improvement of renal survival: a systematic review  and meta-analysis. | journal=PLoS One | year= 2011 | volume= 6 | issue= 4  | pages= e18788 | pmid=21533280 | doi=10.1371/journal.pone.0018788 |  pmc=PMC3075273 | url= }} </ref>
* [[Corticosteroid]]s according to a [[meta-analysis]] of [[randomized controlled trial]]s.<ref  name="pmid21533280">{{cite journal| author=Zhou YH, Tang LG, Guo SL,  Jin ZC, Wu MJ, Zang JJ et al.| title=Steroids in the treatment of IgA  nephropathy to the improvement of renal survival: a systematic review  and meta-analysis. | journal=PLoS One | year= 2011 | volume= 6 | issue= 4  | pages= e18788 | pmid=21533280 | doi=10.1371/journal.pone.0018788 |  pmc=PMC3075273 | url= }} </ref><ref name="pmid10093981">{{cite journal| author=Pozzi C, Bolasco PG, Fogazzi GB, Andrulli S, Altieri P, Ponticelli C et al.| title=Corticosteroids in IgA nephropathy: a randomised controlled trial. | journal=Lancet | year= 1999 | volume= 353 | issue= 9156 | pages= 883-7 | pmid=10093981 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10093981  }} </ref>
** [[Corticosteroid]]s combined with [[azathioprine]] may<ref name="pmid21301920">{{cite journal| author=Stangou M, Ekonomidou D, Giamalis P, Liakou H, Tsiantoulas A, Pantzaki A et al.| title=Steroids and azathioprine in the treatment of IgA nephropathy. | journal=Clin Exp Nephrol | year= 2011 | volume= 15 | issue= 3 | pages= 373-80 | pmid=21301920 | doi=10.1007/s10157-011-0415-3 | pmc= | url= }} </ref> or may not help<ref name="pmid20634300">{{cite journal| author=Pozzi C, Andrulli S, Pani A, Scaini P, Del Vecchio L, Fogazzi G et al.| title=Addition of azathioprine to corticosteroids does not benefit patients with IgA nephropathy. | journal=J Am Soc Nephrol | year= 2010 | volume= 21 | issue= 10 | pages= 1783-90 | pmid=20634300 | doi=10.1681/ASN.2010010117 | pmc=PMC3013548 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20634300  }} </ref>.
** Adding [[azathioprine]] to [[corticosteroid]]s may<ref name="pmid21493743">{{cite journal| author=Kamei K, Nakanishi K, Ito S, Saito M, Sako M, Ishikura K et al.| title=Long-term results of a randomized controlled trial in childhood IgA nephropathy. | journal=Clin J Am Soc Nephrol | year= 2011 | volume= 6 | issue= 6 | pages= 1301-7 | pmid=21493743 | doi=10.2215/CJN.08630910 | pmc=PMC3109925 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21493743  }} </ref><ref name="pmid21301920">{{cite journal| author=Stangou M, Ekonomidou D, Giamalis P, Liakou H, Tsiantoulas A, Pantzaki A et al.| title=Steroids and azathioprine in the treatment of IgA nephropathy. | journal=Clin Exp Nephrol | year= 2011 | volume= 15 | issue= 3 | pages= 373-80 | pmid=21301920 | doi=10.1007/s10157-011-0415-3 | pmc= | url= }} </ref> or may not help<ref name="pmid20634300">{{cite journal| author=Pozzi C, Andrulli S, Pani A, Scaini P, Del Vecchio L, Fogazzi G et al.| title=Addition of azathioprine to corticosteroids does not benefit patients with IgA nephropathy. | journal=J Am Soc Nephrol | year= 2010 | volume= 21 | issue= 10 | pages= 1783-90 | pmid=20634300 | doi=10.1681/ASN.2010010117 | pmc=PMC3013548 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20634300  }} </ref>.
* [[Platelet aggregation inhibitors]] and other anti-hemostatic agents according to [[meta-analysis|meta-analyses]]<ref name="pmid17186331">{{cite journal| author=Taji Y, Kuwahara T, Shikata S, Morimoto T| title=Meta-analysis of antiplatelet therapy for IgA nephropathy. | journal=Clin Exp Nephrol | year= 2006 | volume= 10 | issue= 4 | pages= 268-73 | pmid=17186331 | doi=10.1007/s10157-006-0433-8 | pmc= | url= }} </ref><ref name="pmid22041349">{{cite journal| author=Liu XJ, Geng YQ, Xin SN, Huang GM, Tu XW, Ding ZR et al.| title=Antithrombotic drug therapy for IgA nephropathy: a meta analysis of randomized controlled trials. | journal=Intern Med | year= 2011 | volume= 50 | issue= 21 | pages= 2503-10 | pmid=22041349 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22041349  }} </ref>
* Omega-3 fatty acids ([[fish oil]]) may help.<ref name="pmid7935657">{{cite journal| author=Donadio JV, Bergstralh EJ, Offord KP, Spencer DC, Holley KE| title=A controlled trial of fish oil in IgA nephropathy. Mayo Nephrology Collaborative Group. | journal=N Engl J Med | year= 1994 | volume= 331 | issue= 18 | pages= 1194-9 | pmid=7935657 | doi=10.1056/NEJM199411033311804 | pmc= | url= }} </ref>
* Oral [[calcitriol]] according to a single [[randomized controlled trial]].<ref name="pmid22019331">{{cite journal|  author=Liu LJ, Lv JC, Shi SF, Chen YQ, Zhang H, Wang HY| title=Oral  calcitriol for reduction of proteinuria in patients with IgA  nephropathy: a randomized controlled trial. | journal=Am J Kidney Dis |  year= 2012 | volume= 59 | issue= 1 | pages= 67-74 | pmid=22019331 |  doi=10.1053/j.ajkd.2011.09.014 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22019331  }} </ref>
* Oral [[calcitriol]] according to a single [[randomized controlled trial]].<ref name="pmid22019331">{{cite journal|  author=Liu LJ, Lv JC, Shi SF, Chen YQ, Zhang H, Wang HY| title=Oral  calcitriol for reduction of proteinuria in patients with IgA  nephropathy: a randomized controlled trial. | journal=Am J Kidney Dis |  year= 2012 | volume= 59 | issue= 1 | pages= 67-74 | pmid=22019331 |  doi=10.1053/j.ajkd.2011.09.014 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22019331  }} </ref>
Treatments that have been studied but do not clearly help include:
* Leflunomide and mycophenolate mofetil.<ref name="pmid20650041">{{cite journal| author=Liu XW, Li DM, Xu GS, Sun SR| title=Comparison of the therapeutic effects of leflunomide and mycophenolate mofetil in the treatment of immunoglobulin A nephropathy manifesting with nephrotic syndrome. | journal=Int J Clin Pharmacol Ther | year= 2010 | volume= 48 | issue= 8 | pages= 509-13 | pmid=20650041 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20650041  }} </ref><ref name="pmid18974636">{{cite journal| author=Xu G, Tu W, Jiang D, Xu C| title=Mycophenolate mofetil treatment for IgA nephropathy: a meta-analysis. | journal=Am J Nephrol | year= 2009 | volume= 29 | issue= 5 | pages= 362-7 | pmid=18974636 | doi=10.1159/000168483 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18974636  }} </ref>


==References==
==References==
<references/>
<references/>

Latest revision as of 15:38, 9 September 2020

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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:

Treatments that have been studied but do not clearly help include:

  • Leflunomide and mycophenolate mofetil.[14][15]

References

  1. ↑ Anonymous (2024), IgA nephropathy (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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]
  7. ↑ 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.
  8. ↑ 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.
  9. ↑ 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.
  10. ↑ 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.
  11. ↑ 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]
  12. ↑ 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.
  13. ↑ 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.
  14. ↑ 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]
  15. ↑ 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.
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