Treatment of Progressive IgA Nephropathy: An Update
Treatment of Progressive IgA Nephropathy: An Update
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DOI：
10.1159/000348460
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发表时间：
2013-01-01
期刊：
影响因子：
--
通讯作者：
Chen, Nan
中科院分区：
文献类型：
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作者：
Wang, Weiming;Chen, Nan
伊加肾病（IgAN）是世界范围内最常见的原发性肾小球疾病。大约25-30%的IgAN患者将在20-25年内进展为终末期肾病。高度提示进行性IgAN的早发症状包括大量蛋白尿、高血压、肾损害、肾小球硬化、新月体形成和肾小管间质纤维化。进展性IgAN可在短时间内进展为肾衰竭。优化的支持治疗是进展性IgAN患者的基本治疗方法，包括血浆血管紧张素系统阻滞剂、血压控制、抗血小板和抗凝药物、他汀类药物和别嘌呤醇。在临床和病理表现更严重的进行性IgAN患者中，可以考虑积极治疗，包括糖皮质激素治疗、环磷酰胺、硫唑嘌呤、吗替麦考酚酯、他克莫司和其他免疫抑制剂。然而，目前对进行性IgAN的定义和治疗存在争议。版权所有（C）2013 S. Karger AG，巴塞尔
IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. About 25-30% of IgAN patients will progress to end-stage kidney disease in 20-25 years. Early-onset symptoms that are highly suggestive of progressive IgAN include massive proteinuria, hypertension, renal damage, glomerular sclerosis, crescent formation, and tubulointerstitial fibrosis. Progressive IgAN may progress to renal failure in a short time. Optimized supportive therapy is the fundamental treatment for progressive IgAN patients, and includes renin-angiotensin system blockers, blood pressure control, antiplatelet and anticoagulant drugs, statins, and allopurinol. In progressive IgAN patients whose clinical and pathological manifestations are more severe, active therapy may be considered including glucocorticoid therapy, cyclophosphamide, azathioprine, mycophenolate mofetil, tacrolimus, and other immunosuppressants. However, there are currently controversies on the definition and treatment of progressive IgAN. Copyright (C) 2013 S. Karger AG, Basel