What are the MHLW/JSN treatment guidelines for immunoglobulin A (IgA) neuropathy in patients with chronic kidney disease?

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

In patients with urinary protein level ≥1 g/day and chronic kidney disease (CKD) stage G1-3b, the guidelines give a strong recommendation (grade A) for the use of ACEI or ARB therapy to control progression of renal dysfuntion. In patients with urinary protein level ≥1 g/day and chronic kidney disease (CKD) stage G1-2, the guidelines recommendations include the following:

  • High-dose oral steroid therapy: prednisolone at 0.8–1.0 mg/kg for about 2 months, followed by gradual tapering over about 6 months (grade B)
  • Steroid pulse therapy: methylprednisolone 1 g for 3 days by infusion (or IV) every other month, 3 times plus prednisolone 0.5 mg/kg, every other day, for 6 months (grade B) 

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