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>


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* [[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 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>
** 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>.
** 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]] according to a [[meta-analysis]]<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>
* [[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>
* 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>

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.