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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Supportive treatment, including administering angiotensin-receptor blockers (ARBs) and salt restriction, should be administered to all IgAN patients (1)

  • importance of conservative therapy to reduce proteinuria and slow the rate of renal function decline in IgAN cannot be overemphasized (2)

A low protein diet is also advisable in nephrotic IgA nephropathy patients (1)

If recurrent chronic tonsillar infections then tonsillectomy is indicated

Use of immune-suppressive agents depends mainly upon the progression rate, comorbidities, and histopathological changes of the kidney biopsy (1):

  • corticosteroids are currently the cornerstone of IgA nephropathy
    • NICE have stated that
      • Targeted-release budesonide is recommended as an option for treating primary immunoglobulin A nephropathy (IgAN) when there is a risk of rapid disease progression in adults with a urine protein-to-creatinine ratio of 1.5 g/g or more (3)

it is an add-on to optimised standard care including the highest tolerated licensed dose of angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), unless these are contraindicated

  • different therapeutic agents such as calcineurin inhibitors (CNIs), cyclophosphamide, mycophenolate mofetil, rituximab, and leflunomide (LEF) are used, but none is approved as a single or combined effective therapy for IgA nephropathy

Reference:

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