How to treat and care for IgA nephropathy? All your concerns are here!

The drug treatment of IgA nephropathy is based on the results of current medical research. The treatment principles for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, glucocorticoids (referred to as "hormones"), and immunosuppression commonly used in the treatment of IgA nephropathy are as follows:

01Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers: IgA nephropathy patients with proteinuria exceeding 0.5 g/day or hypertension (＞130/80 mmHg) should be treated with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers.

02 For patients whose proteinuria persists at more than 1 g/day after treatment with angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, it is recommended to add hormone treatment for 6 to 8 months.

03 For patients with progressive IgA nephropathy (serum creatinine increases by more than 15% per year, or serum creatinine 133-250 micromol/L) and pathological glomerular sclerosis of no more than 50%, hormones combined with cyclophosphamide can be used for treatment. It can also be combined with other immunosuppressants, such as mycophenolate mofetil, azathioprine, cyclosporine A, etc., but the efficacy needs further study and observation.

04 Other treatment measures: Most studies have shown that tonsillectomy may help alleviate acute episodes of hematuria and proteinuria. A prospective randomized controlled study from the United States showed that taking 6 to 12 grams of fish oil per day has a protective effect on renal function in patients with progressive IgA nephropathy. However, the above study has not been confirmed by other studies.

Since IgA nephropathy is a chronic progressive disease, as more randomized controlled studies are conducted, there will be better evidence to guide clinicians in choosing treatment options and delay the progression of renal function damage in patients.

How to care for individuals with IgA nephropathy

0 1 Actively prevent upper respiratory tract infection. Patients with repeated tonsillitis-induced hematuria and abnormal urine test can undergo resection. Increase disease resistance, avoid cold, and reduce the chance of infection. Once various infections occur, strong antibiotics should be used in time to control the infection as soon as possible.

0 2 Ensure adequate sleep, sleep time should be more than 8 hours a day, rest in bed until the naked eye hematuria disappears, and give a low-salt, low-fat, low-phosphorus, high-calcium, high-quality low-protein diet, such as milk and fish. In addition, pay attention to eating less animal offal and foods that are prone to allergies.

0 3 Strengthen skin care and keep the skin intact. Instruct the patient to take a bath and change underwear frequently, trim his/her nails, and choose non-irritating or less irritating toiletries.

0 4 During the acute macroscopic hematuria period, take adequate rest and avoid strenuous exercise. However, when the condition is stable, you can do appropriate exercise, such as practicing Qigong and Tai Chi. It should be noted that although IgA nephropathy with clinical manifestations of hematuria is a relatively benign pathological process, it also has the risk of deterioration. It should not be completely ignored, nor should it be too anxious or radical. Especially for some patients, multiple urine routine tests have shown urine occult blood +, without other discomfort. The treatment method for these patients is: no need for excessive treatment, do not blindly seek medical treatment to eliminate "hematuria", and regular follow-up is the key.

0 5Drug treatment should be carried out under the guidance of a doctor, and avoid the use of drugs that are harmful to the kidneys, such as gentamicin, amikacin, etc.