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IgA Nephropathy

Monzurul H. Chowdhury, MD and Jahan Montague, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Most common form of glomerulonephritis in the world

  • Renal parenchymal damage and dysfunction defined by deposition of IgA in glomerular mesangium

  • Significant contributor to the inciden...

DIAGNOSIS

HISTORY

40–50% of patients present with painless recurrent episodes of macroscopic hematuria concurrent to or immediately after upper respiratory infections (1). 

PHYSICAL EXAM

  • Hypertension

  • Edem...

TREATMENT

MEDICATION

First Line

  • Use angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) to achieve blood pressure (BP) target of 125/75 mm Hg and decrease proteinuria ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Patients with mild proteinuria (≤500 mg/day), normal renal function, and normal BP may be treated conservatively with regular follow-up at 6-month intervals.

  • Patie...

REFERENCES

1
Manno C, Torres DD, Rossini M, et al. Randomized controlled clinical trial of corticosteroids plus ACE-inhibitors with long-term follow-up in proteinuric IgA nephropathy. Nephrol Dial Tran...

ADDITIONAL READING

  • Floege J, Eitner F. Current therapy for IgA nephropathy. J Am Soc Nephrol.  2011;22(10):1785–1794.

  • Kidney Disease: Improving Global Outcomes (KDIGO) Glomerulonephritis Work Grou...

CODES

ICD10

N02.8 Recurrent and persistent hematuria with other morphologic changes 

ICD9

583.9 Nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidne...

CLINICAL PEARLS

  • IgAN is the most common cause of glomerulonephritis in the world.

  • Risk factors for progressive disease include persistent microscopic hematuria, moderate to severe proteinuria, and fibr...

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