6 Effective Treatment Methods for IgA Nephropathy
IgA Nephropathy is the most common chronic glomerulonephritis, which often presents gross hematuria after a cold. And it is also one of the main causes of uremia.
Causes of IgA Nephropathy
After infection of respiratory mucosa, gastrointestinal mucosa and genital mucosa, human body will produce a large number of glycosylated IgA1, which stimulates the abnormal immune system to form immune complexes. With blood circulation, they go into kidneys, inducing immune inflammation in the kidney. This is IgA Nephropathy.
IgA nephropathy caused by different infections has different severity of illness conditions. Some are asymptomatic hematuria, some are naked hematuria, some are mild albuminuria, some are massive albuminuria, some will be accompanied by hypertension, crescent formation, and eventually turn to uremia, some have no obvious symptoms throughout their lives. In a word, the difference is quite large. Hematuria with mild to moderate proteinuria is more common in clinic, and 40% of patients have hypertension.
If the urinary protein exceeds 3.5g/24h, or if there is gross hematuria or hypertension, it indicates that the disease will progress faster, and it often takes about 10-20 years to develop into uremia. If there is only a small amount of occult blood and urinary protein, the prognosis is generally better.
How should IgA Nephropathy be treated?
1. ACEI or ARBs
IgA nephropathy with hypertension often indicates poor prognosis and should be treated actively. ACEI or ARBs should be the first choice for treatment. They can also reduce urinary protein while lowering blood pressure.
In most patients with IgA nephropathy and elevated blood pressure, one antihypertensive drug is often ineffective and requires combination of calcium antagonists, diuretics and beta-blockers.
2. Chinese Medicine
IgA nephropathy has not yet been treated with specific drugs. For many patients, their proteinuria can not get complete remission after routine treatment. In such a case, Chinese Medicine Treatment can be used together. Patients can use Traditional Chinese Medicine after syndrome differentiation in large-scale Chinese medicine hospitals, which can improve marked efficiency.
3. Fish oil
The effect of fish oil is not clear, but its side effects are few. Some IgA nephropathy patients have decreased urinary protein after taking fish oil. After 3 months of ACEI or ARBs treatment, if 24-hour urinary protein level has not been reduced to less than 1 g, fish oil treatment may be considered. Generally, imported fish oil has higher purity and obvious efficiency. After taking, pay attention to monitoring urinary protein and serum creatinine to see if it is effective.
4. Steroids and immunosuppressants
If the 24-hour urinary protein of IgA nephropathy patients has not been reduced to less than 1 g after treatment with ACEI or ARBs and traditional Chinese medicine, it is necessary to consider the use of steroids (prednisone) and/or other immunosuppressive agents to inhibit renal inflammation and alleviate proteinuria.
IgA nephropathy is generally not too sensitive to steroids, and its side effects are large, so it is necessary to carefully grasp the indications. "Low-dose steroids + leflunomide" is often better than steroid alone, and its side effects are smaller and safer.
Tonsillectomy can alleviate clinical symptoms, reduce proteinuria and delay disease progression, but not all IgA nephropathy requires tonsillectomy, and its advantages and disadvantages need to be weighed. If frequent tonsillectomy infection causes IgA nephropathy recurrence, tonsillectomy may be performed.
6. Other treatments
Most IgA nephropathy patients have low immunity and need antibiotics after bacterial infection.
Patients with edema need diuretic treatment. Thiazide diuretics (such as hydrochlorothiazide tablets) or loop diuretics (furosemide) can be used.
Patients with elevated cholesterol may use statins (such as atorvastatin or simvastatin).
Some diuretics and lipid-lowering drugs also have the effect of reducing urinary protein.
In conclusion, IgA nephropathy generally does not progress very fast, but lack of specific drugs, and it is prone to renal failure if it can not be controlled well for long term. Most patients need standard comprehensive treatment and follow-up once a month to 3 months. To avoid renal failure and uremia, we should keep communication with doctors and adjust drugs in time during treatment. For more information on IgA Nephropathy, please leave a message below or contact online doctor.
***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***