《《IgA肾病治疗进展》.pdf

BRIEF REVIEW Current Therapy for IgA Nephropathy Ju¨ rgen Floege and Frank Eitner Division of Nephrology and Immunology, RWTH University of Aachen, Aachen, Germany ABSTRACT IgA nephropathy (IgAN) is a very common glomerulonephritis worldwide. In this are detected in 5 to 20% of all cases. Full- review, we discuss therapeutic options in four clinical scenarios encountered in blown IgAN with glomerular IgA plus C3 patients with IgAN: first is the patient with minor urinary abnormalities where the deposits as well as mesangioproliferative mainstay of treatment is long-term, regular follow-up to detect renal progression changes were noted in 1.6% of Japanese and hypertension. Second is the typical patient presenting with microhematuria, graft kidneys before implantation.2 Thus, significant but non-nephrotic proteinuria, hypertension, and variable degrees of the majority of patients with IgAN must renal failure. Here the mainstay of treatment is optimized supportive care. If this run a clinically inconspicuous course does not lower proteinuria below 1 g/d, corticosteroid monotherapy may be and spontaneous remissions of the dis- effective, as long as the GFR is above 50 ml/min. There is insufficient data to ease must exist. Indeed, in Chinese IgAN advocate the use of other immunosuppressive drugs or even combination therapy patients with isolated microhematuria in such patients. Third is the atypical patient with overt nephrotic syndrome, or followed for up to 12 years, microhema- acute or rapidly progressive kidney injury where a possible vasculitic form of IgAN turia disappeared in 14%, and in less should be sought and, if present, treated