genitourinary disorders
Immunoglobulin A Nephropathy
Introduction
Immunoglobulin A (IgA) nephropathy is deposition of IgA immune complexes in glomeruli, manifesting as slowly progressive hematuria, proteinuria, and, often, renal insufficiency. Diagnosis is based on urinalysis and renal biopsy. Treatment options include angiotensin-converting enzyme (ACE) inhibitors,angiotensin IIreceptor blockers (ARBs), corticosteroids and sometimes other immunosuppressants. Prognosis is generally good. (See also Overview of Nephritic Syndrome .) IgA nephropathy is a nephritic syndrome, a form of Chronic glomerulonephritis characterized by the deposition of IgA immune complexes in glomeruli. It is the most common form of glomerulonephritis worldwide. It occurs at all ages, with a peak onset in the teens and 20s; affects men 2 to 6 times more frequently than women; and is more common in White and Asian people than in Black people. Prevalence estimates for IgA kidney deposits are 5% in the United States, 10 to 20% in southern Europe and Australia, and 30 to 40% in Asia. However, some people with IgA deposits do not develop clinical disease. Cause is unknown, but evidence suggests that there may be several mechanisms, including Increased IgA1 production Defective IgA1 glycosylation causing increased binding to mesangial cells Decreased IgA1 clearance A defective mucosal immune system Overproduction of cytokines stimulating mesangial cell proliferation Familial clustering has also been observed, suggesting genetic factors at least in some cases. Renal function is initially normal, but symptomatic renal disease may develop. A few patients present with Acute Kidney Injury (AKI) or 