Friday, August 3, 2012

Treatment principle for IgA nephropathy


IgA nephropathy, also known as IgA nephritis, Berger's disease, IgA mesangial glomerulonephritis, membrane deposition of IgA-IgG nephritis. IgA, immunoglobulin A, immunoglobulin is mainly present in the plasma with antibody activity, or the chemical structure and similar antibody globulin. IgA nephropathy is the most common form of primary glomerulonephritis, accounting for primary glomerulonephritis 1/3. IgA nephropathy is characterized by: recurrent gross hematuria or microscopic hematuria, glomerular mesangial District, there are structural abnormalities of the IgA1 wide range of deposition, while the increase in mesangial cells and matrix proliferation, mesangial electron dense deposits. about 15% to 20% of patients with lgA nephropathy can enter in the 10 years after the onset of end-stage renal failure. At present, the principle treatment of IgA nephropathy are as follows:


(1) general treatment for upper respiratory tract infection, gross hematuria, the application of effective antibiotic treatment; patients with hypertension should actively control blood pressure, in order to avoid hemodynamic abnormalities and vascular lesions aggravate nephritis disease; with recurrent gross hematuria attack patients can be considered for tonsillectomy. It is reported that the tonsils lesions, allows more than 40% of IgA nephropathy with hematuria patients have been alleviated.


(2) regulate the immune response of prednisone treatment of IgA nephropathy, about 40% response rate; combined use of dipyridamole, cyclophosphamide, phenytoin (daily 6mg/kg), serum IgA levels can decline; oral Cyclosporin A daily 5mg/kg, proteinuria can reduce.


(3) to remove immune complexes in the blood circulation to remove immune complexes in the blood circulation, giving IgA nephropathy in patients with gluten-free diet for 6 months to 4 years, blood IgA decreased proteinuria and hematuria were significantly improved. Application of cromolyn sodium daily 1.2g, can reduce proteinuria. IgA nephropathy in renal failure, plasma exchange, some treatment, proteinuria, hematuria disappeared and renal function returned to normal.


(4) decrease in glomerular mesangial IgA deposition can be used acetylene the hydroxyl Androstene isoxazole daily 200mg, four months after treatment, C3 increased, decreased urinary protein. Application of 20 peptide acid, fish oil (daily 1.6g), can delay the deterioration of renal function of patients with IgA nephropathy.


(5) application of traditional Chinese medicine of traditional Chinese medicine preparations madder diester, daily 0.3g hematuria patients with IgA nephropathy have a certain effect.

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