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These risk factors for IgA nephropathy should not be ignored

IgA kidney disease is one of the highest rates of kidney disease in the country. Although the incidence of diabetic nephropathy has been falling, it is still important to ignore the disease. Due to the large changes in the course of the dis...

These risk factors for IgA nephropathy should not be ignored

May 03, 2017 by Kidney Disease Expert

IgA kidney disease is one of the highest rates of kidney disease in the country. Although the incidence of diabetic nephropathy has been falling, it is still important to ignore the disease. Due to the large changes in the course of the disease, 15% to 40% of patients eventually develop end-stage nephropathy (ESRD). Fly the doctor again, therefore, to introduce a risk factor for IgA nephropathy, if we can know about these risk factors and to give proper control, it is meaningful to have to delay the progress of the disease.

Currently recognized as risk factors that affect the disease include: renal insufficiency, and proteinuria and glomerular sclerosis, crescent formation, and renal interstitial fibrosis, with renal insufficiency, and proteinuria is the most important two indicators affect after the rain.

proteinuria

Most scholars are more agree with the urine protein > 1.0 g / 24 h are independent risk factors of IgA nephropathy progress, that is to say, as long as proteinuria more than 1 g, then the disease will progress quickly, even if the other risk factors control very well. Therefore, active control of proteinuria is very significant for delaying the progression of the disease. And the control of the proteinuria way I have told it in the relevant chapters of IgA nephropathy, including RAS blockers titration therapy and hormone therapy, tripterygium wilfordii more glucoside piece also is very effective for some patients. But these drugs must be monitored by doctors.

Renal insufficiency

This indicator although is very important, but after all belong to the past, that is to say whether it is a disease of kidney function or the index has now is already exist, therefore, can be little chance of treatment. But some patients with rapid kidney development may mean a progression of pathology, so repeat the kidney biopsy if necessary.

High blood pressure

High blood pressure plays an important role in the development of kidney function. This should be pided into two aspects: first, the damage to the kidney hypertension has been recognized, especially in patients with proteinuria > 1 g / 24 h blood pressure is particularly important, it is best to its control to the ideal state, namely 125/80 MMHG, but if it is the elderly are considered separately. Second, high blood pressure, which also affects other organs such as the heart, is one of the major risk factors for death. So as a controlled indicator, patients with IgA nephropathy should focus on blood pressure control.

Crescent formation

IgA nephropathy is often incorporated in the formation of new crescents, and when the number of new moons exceeds 50 percent of the total number of glomeruli of the kidney biopsy, it is known as the new crescent nephritis.

Now that accumulate in baumann's capsule wall may constitute crescents with mononuclear cells, epithelial cells of the cellular elements, fibroblast cells and T cells, these cells except epithelial cells there are two main sources: one from the glomerular capillary pathological changes (including capillary loops necrosis), peripheral blood mononuclear macrophages by vessels within the lumen of the baumann's migration; Another possible originated in baumann's thecal sac lesions, including baumann's capsule wall fracture, ball weeks or interstitial inflammatory cells and fibroblast cells in baumann's chamber.

The new moon usually means an acute progression of the disease, usually in the form of acute nephritis syndrome. Most patients will develop uremia in the short term if they do not receive timely and effective treatment.

 

The treatment of the new moon is currently advocated for hormone shock therapy, but the IgA kidney disease guide is available.

Glomerular sclerosis and renal interstitial fibrosis

Currently accepted the two measures is a sign of chronic, because of the characteristic of the kidney of non-renewable, the higher the level of glomerular sclerosis or fibrosis, the less the function of the kidney, glomerular filtration rate is lower.

Given all this, as the related risk factors for IgA nephropathy patients should get to know more, want to know, at the same time as the two factors can control the IgA nephropathy: blood pressure and proteinuria level, should be taken seriously enough. It is best to control the proteinuria within 1 g, and the blood pressure needs to be at least 140/90mmhg, except for the elderly, if it should be controlled at 125/80mmhg.

 


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