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How to avoid uremia in IgA nephropathy patient?

2018-01-26 16:31

IgA nephropathy is one of the most common types of primary glomerulonephritis. Kidney disease experts have analysed more than 10,000 cases of renal biopsy. The final diagnosis of IgA nephropathy accounts for up to 45% of primary glomerulonephritis (the most common secondary glomerulonephritis is lupus nephritis) with the development of evidence-based medicine. In fact, the prognosis of this disease has improved a lot.

How to avoid uremia in IgA nephropathy patient?

IgA nephropathy refers to a disease in which a protein, called "IgA", is deposited in the kidneys. Patients with IgA nephropathy usually have two main clinical manifestations:

In the cold soon after the appearance of naked hematuria, and the naked eye hematuria in a few years often recurred; Or continuous asymptomatic hematuria under the mirror (invisible to the naked eye, can be seen through the microscope hematuria. That is, hematuria is a prominent feature of IgA nephropathy. Some patients with hematuria also accompanied with proteinuria. IgA nephropathy with simple proteinuria is rare. The final diagnosis depends on renal biopsy.

Because renal biopsies are usually recommended in patients with proteinuria greater than 0.5 g / day, a portion of mild IgA nephropathy is only hematuria or hematuria with microalbuminuria. There was no diagnosis of renal puncture.

In patients with IgA nephropathy, the management of indicators is different, the prognosis is very different. The control level of mean proteinuria. It is the most important predictor of renal outcome in IgA nephropathy: the complete or partial improvement of proteinuria indicates that the prognosis of IgA nephropathy is good.

Having high blood pressure at the time of diagnosis, or a rise in blood pressure after onset (e.g., from 100 / 60 mmHg to 130 / 80 mmHgg / g), indicates a high risk of progression, if not treated. Hypertension can lead directly to the progression of nephropathy. Patients with blood pressure below 130/80 have better outcomes.

In a Japanese study, 2270 patients with IgA nephropathy were followed up for an average of seven years. The researchers found that the diagnosis of serum creatinine was significantly different in patients with different outcomes, with serum creatinine greater than 148 umol / l. The incidence of end-stage renal failure was more than 20 times higher in patients with serum creatinine lower than 111 umol / l.

Other risk factors for improvement include obesity, hyperlipidemia, hyperuricemia, hyperglycemia, smoking, and nephrotoxic drugs.

Therefore, early attention to kidney disease screening, urine protein, blood pressure control standards, protect renal function to maintain the stability of serum creatinine concentration, control obesity and other risk factors of kidney disease, all aspects of good management. IgA Kidney Friends need not worry too much about the occurrence of uremia.

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