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Treatment of IgA nephropathy requires a long way to go

In the case of corpse kidney transplantation, the survival rate of transplanted kidneys was up to 87% and 77% in 1 year and 3 years. However, IgA renal transplant recipients with IgA antibodies with anti-HLA antigens alone had a survival rate of 100% It is reasonable to assume that these anti-HLA antigens have a beneficial effect on increasing graft survival. ...

So far, the disease is not satisfied with the treatment program. The use of adrenal cortical hormone with or without immunosuppressive agents in patients with progressive renal dysfunction is not consistent. Recent data suggest that more than 1 g / d of proteinuria, the application of the next day the application of adrenal cortex hormones on the improvement of proteinuria beneficial. Small IgA nephropathy with IgA deposition may alleviate proteinuria. Combined with cyclophosphamide, dipyridamole and Huafu Lin can reduce proteinuria and glomerular filtration rate had no effect; combined with cyclosporine A can also reduce proteinuria, but also reduce creatinine clearance rate. Phenytoin, antiplatelet drugs, disodium chromophosphate, diphenylhydantoin and other drugs is not sure. Although urokinase can be reported to protect the role of glomerular filtration rate, but far from conclusion. Repeated tonsilitis, tonsil resection may be beneficial; antibiotic prophylaxis and treatment of infection for some of the acute nephritis syndrome and acute renal failure may be helpful. A smaller series of observations found that the use of fish oil preparations had the effect of reducing proteinuria and increasing glomerular filtration rate.

Severe IgA nephropathy (glomerular filtration rate decreased by 2 ~ 4ml / min per month) during the use of large doses of immunoglobulin intravenous infusion, can stop glomerular filtration rate decreased, improve hematuria and proteinuria, but after stopping Often recurrence. For patients with hypertension and severe proteinuria, the use of converting enzyme inhibitors can slow down the rate of glomerular filtration rate and reduce proteinuria, so in severe IgA nephropathy, the conversion enzyme inhibitor is the preferred antihypertensive drug. It is unclear whether the conversion of normal blood pressure inhibitors is effective.

Endometrial IgA nephropathy after renal transplantation, the transplanted kidney soon occurs mesangial IgA deposition; if the donor who have subclinical IgA nephropathy, non-IgA nephritis after uremia, donor mesangial area IgA sediment often Quickly disappear. Transplantation of the kidneys with recurrent IgA nephropathy does not necessarily occur in progressive renal failure, but after renal transplantation, immunosuppressive therapy, including cyclosporine A can not prevent its development. In the case of corpse kidney transplantation, the survival rate of transplanted kidneys was up to 87% and 77% in 1 year and 3 years. However, IgA renal transplant recipients with IgA antibodies with anti-HLA antigens alone had a survival rate of 100% It is reasonable to assume that these anti-HLA antigens have a beneficial effect on increasing graft survival.

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