How is glomerulonephritis managed in immunoglobulin A (IgA) nephropathy?

Updated: Feb 15, 2018
  • Author: Sohail Abdul Salim, MD, FASN, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

IgA nephropathy is a common cause of glomerulonephritis. Although it is a benign disease in most patients, chronic kidney disease and end-stage renal disease (ESRD) occur in about 20-40% of patients within 20 years of presentation. Currently, multiple treatment options are available; no one therapy is appropriate for all patients.

Current recommendations include the following:

  • In patients with isolated hematuria (ie, without proteinuria or hypertension) monitor with urinalysis, renal function testing, and blood pressure measurement.

  • Treat hypertension early and aggressively with renin-angiotensin blockade; a reasonable goal is to aim for a blood pressure of 130/80 mm Hg. [21]

  • Steroids are most beneficial if more than 1 g of proteinuria is present in a 24-hour urine specimen. [22]


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