The most common clinical presentation of Ig A nephropathy is bloody urine provoked by upper respiratory infection. Infectious source with microbial and viral infection is occasionally present. Food particles have also been proposed. Alternatively, Ig A naphropathy may be an autoimmune disease. Ig A Nephropathy is one of the most common causes of kidney disease. In Caucasians, Ig A nephropathy is more common in men with ratio of 3:1 than women. However, in Asians, the ratio approached 1:1. This disease can be transient or progress to chronic kidney disease and possible end stage renal disease requiring dialysis.
Ig A nephropathy is associated with other diseases such as rheumatoid arthritis, celiac disease, alcohol liver disease, cirrhosis, dermatitis herpetiformis, and HIV/AIDS.
The clinical presentation may be suggestive of Ig A nephropathy. However, renal biopsy is required for confirmation. Kidney biospay further helps for predicting the course of the disease. That being said, not all patients require to have kidney biopsy.
Some patient with mild disease have remission. However, the presence of high blood pressure, protein in the urine, and reduced kidney function as well as some findings on kidney biopsy increase progression and poor outcomes.
Treatment of Ig A nephropathy depends to clinal presentation, urine studies and kidney biopsy result. Depending to the presentation, the treatment of Ig A nephropathy varies from blood pressure medications to immunosuppresive medications. Close follow up with a nephrologist is crucial.
Dietary gluten restriction has not been show to preserve kidney function.
Ardavan Mashhadian D.O.
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