IgA Nephropathy: Cause, Symptoms, Treatments, and Latest Research

Posted by beauty33 on December 23rd, 2021

IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide and can cause a severe decline in kidney function. The clinical presentation of IgAN varies widely, with some patients presenting with mild urinalysis abnormalities and, in severe cases, acute progressive glomerulonephritis. In addition, the clinical prognosis of IgAN varies, with very few patients in spontaneous remission, but about 40% of IgAN patients may progress to end-stage renal disease (ESRD) within 20 years of disease onset, at which point renal replacement therapy is required.

What is the cause of IgAN?

The cause of IgAN is not fully understood. IgAN is not just a kidney disease, it is a response of the immune system (the body\'s defense system) to external stimuli (such as viral infections). The immune response is what affects the kidneys. The immune response releases immunoglobulin A (IgA), a protein that helps the body fight infection. IgAN is developed when IgA proteins become trapped in the kidneys and create an inflammatory response.

The inflammatory response causes the kidneys to leak blood and protein (usually very quickly), and over many years, the kidneys may lose function, leading to kidney failure. In some cases, the disease appears to be concentrated in certain families or in certain areas. IgAN rarely occurs in African populations. Some researchers believe that genetic factors may play a role in the development of the disease.

What are the signs and symptoms of IgAN?

Signs and symptoms may be different for each person with IgAN. The most common signs include: (1) Hematuria: the presence of blood in the urine, which sometimes makes the urine dark brown or cola-colored. (2) Proteinuria: foam in the urine due to a large amount of protein leaking into the urine.

How to treat IgAN?

Measures to delay the progression of kidney function may include the following:

1. Glucocorticoids and immunosuppressive drugs: these are used to calm the immune system (the body\'s defense system) and stop it from attacking the glomeruli.

2. ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin-receptor blockers): these are blood pressure-lowering drugs that are used to reduce urinary protein loss and control blood pressure.

3. Dietary changes: some dietary changes may be required, such as reducing salt (sodium) and protein intake in food to reduce the burden on the kidneys to process metabolic waste.

4. Fish oil supplements: doctor may recommend vitamin supplements in the form of fish oil. Some studies have shown that this may help treat IgAN.

What’s new in IgAN treatment research?

In November 2019, a team of scientists led by Byung Chul Yu examined changes in urinary mtDNA in IgAN patients. The findings revealed that urinary ND1 and COX3 copy levels are highly connected, and they are greater in the IgAN group than in the HVs, indicating that mitochondrial damage is connected to IgAN.

In March 2021, another scientist team leading by Li Tan published a paper titled A multicenter, prospective, observational study to determine association of mesangial C1q deposition with renal outcomes in IgA nephropathy. They proved that glomerular deposition of C1q is associated with worse clinicopathologic features and renal outcomes in IgAN patients. Mesangial C1q deposition is an independent risk factor for poor renal prognosis in IgAN.