IGA Nephropathy - IGA NEPHROPATHY Anjali Gupta MD...

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Unformatted text preview: IGA NEPHROPATHY Anjali Gupta, MD Epidemiology ¡ Most common cause of primary glomerulonephritis ¡ Peak incidence in 2 nd to 3 rd decade of life ¡ 2:1 male to female ratio ¡ Most common in Caucasians and Asians ¡ Described in 1968 by Dr Berge Clinical Presentations ¡ 40-50% present with gross hematuria, usually following an upper respiratory infection- classic presenation ¡ 30-40% present with microscopic hematuria and non- nephrotic proteinuria ¡ <5% present with nephrotic syndrome ¡ <5% acute RPGN Diagnosis Renal Biopsy Pathology — Light Microscopy Pathological Classification Am J Kidney Dis 49:763-775 . Survival curves for ESRD Oxford MEST score KI:2009 Pathogenesis: Characteristics of IgA in IgAN Pathogenesis Reduction in glycosylation Polymeric Ig A1 Ig G autoantibodies Binding to FcR Receptors on MC Decrease clearance by liver CIC In situ IC Mesangial Inflammation Clinical Prognostic Markers Poor Prognosis: ¡ Severity of proteinuria ¡ HTN ¡ Renal impairment ¡ Increasing age ¡ Duration of preceding symptoms ¡ Increased BMI Good Prognosis: ¡ Recurrent macroscopic hematuria No Impact on Prognosis: ¡ Gender ¡ Ethnicity ¡ Serum IgA level Prognosis ¡ 15% to 40% of adults and children will progress to ESRD ¡ 15 to 20% develop ESRD within 10 years of onset ¡ 30 to 35% develop ESRD within 20 years of onset Treamtment ¡ Conservative treatment ¡ ACE inbitors ¡ Steroids ¡ Cytotoxic agent ¡ Combination therapies ¡ Others- Fish Oil Conservative Treatment ¡ Normal renal function, normotension and only minor urinary abnormalities, such as isolated microscopic...
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IGA Nephropathy - IGA NEPHROPATHY Anjali Gupta MD...

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