Thoughts on treatment of IgA nephropathy

IgA nephropathy (IgAN) is the most common primary glomerular disease in China. It is pathologically characterized by IgA immunoglobulin deposit in glomeruli, with hematuria, proteinuria, hypertension, and renal dysfunction as the major clinical manifestations. Each attack of hematuria and/or proteinuria is the sign of glomerular injury. Without effective intervention, it gradually progresses to renal dysfunction. Controlling hematuria and/or proteinuria, and reducing frequency of recurrent urine abnormalities are the key to treat IgAN and prevent chronic renal injury. ACEI and ARB are superior to other antihypertensive drugs in reducing proteinuria, protecting residual renal function, and delaying the progression of IgAN to ESRD. Combined use of corticosteroids and / or immunosuppressive agents may be considered for treatment of IgAN with substantial crescents, hematuria, and proteinuria. As IgAN has a chronic process, long-term follow-up appears especially important to improve the prognosis. Key words: IgA nephropathy; Mucosal immunity; Hematuria; Proteinuria; Treatment