What are the Kidney Disease: Improving Global Outcomes (KDIGO) treatment guidelines for immunoglobulin A (IgA) neuropathy?

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

KIDGO recommendations for IgA nephropathy treatment include the following [26] :

  • Long-term therapy with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) is recommended for patients with proteinuria >1 g/day \ with up-titration of the drug based on blood pressure (grade 1B).
  • ACEI or ARB therapy is suggested for proteinuria of 0.5-1 g/d (grade 2D).
  • Upward titration of the ACEI or ARB as far as tolerated is suggested, to achieve proteinuria of 1 g/d (grade 2C).
  • Blood pressure treatment goals: 1 g/d (not graded)
  • A 6-month course of corticosteroid therapy may be given to patients who have persistent proteinuria ≥1 g/d despite 3–6 months of optimized supportive care (including ACEI or ARB treatment and blood pressure control), and a GFR >50 ml/min/1.73m 2 (grade 2C).
  • Fish oil may be given to patients who have persistent proteinuria ≥1 g/d despite 3–6 months of optimized supportive care (including ACEI or ARB treatment and blood pressure control) (grade 2D).

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