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IgA Nephropathy, First reported in France in 1968, it was thought to be a benign disease with no renal impairment. However, it was later found that more than 30% of patients develop end-stage renal failure 10-20 years after the onset, and not all IgA nephropathy is a benign state. 30%This data is the beginning of the major IgA nephropathy studies rate is quite high. Kidney friends are full of fear, what should we do? Is it that no matter how I treat it, I will eventually be the 30% of people who inevitably develop uremia?
This is because the body will produce antibodies against pathogens in order to remove the “invader” during a cold. immunoglobulinWhite A (ie, pathogenic IgA), this type of immunoglobulin forms macromolecular complexes with other substances and deposits in the mesangial area of the kidney, causing kidney damage, resulting in gross hematuria.
Not only upper respiratory tract infections such as colds can induce IgA nephropathy, but other infections such as skin infections, Urinary system infection, intestinal infection, etc. may cause some immune abnormalities, and these immune abnormalities may induce the onset of IgA nephropathy. There are also some people who do not have gross hematuria episodes, but begin to pay attention when they find microscopic hematuria on physical examination. In addition to hematuria, some patientswill be accompanied by proteinuria or hypertension, and a small number of patients will have abnormal renal function at the onset. Therefore, the onset and aggravation of IgA nephropathy are closely related to infection. It is very necessary for kidney friends to strengthen their physique and actively reduce infection to prevent uremia.
Proteinuria affects far Much more than hematuria
Many studies have clearly confirmed that poor control of proteinuria is one of the most important factors in the worsening of kidney disease , the same is true for IgA kidney friends.
We can look at the following long-term follow-up study data:
The line of complete remission of proteinuria (less than 0.3g) is almost a straight line, which means that patients with IgA nephropathy who have sustained remission of proteinuria have a high probability of uremia Small.
The more protein in the urine, the more the corresponding line decreases over time, which means Patients with poorer proteinuria control were associated with a correspondingly higher risk of developing uremia.
RAS blocker, it is a first-line renal protein-lowering drug for IgA nephropathy functional drugs.
In addition, glucocorticoids, immunosuppressants, SGLT2i It has been proven to reduce proteinuria and protect renal function in patients with IgA nephropathy.
Everyone is always worried about the effect of occult blood on renal function. far more than hematuria. The effect of hematuria on the progression of nephropathy is still controversial. For kidney patients with a large number of red blood cells, actively look for infection lesions, especially some hidden lesions, such as tonsillitis, periodontitis, dental caries, acne, gastric Intestinal infections, urinary tract infections, perianal infections, etc., after many patients have dealt with the infection lesions, the red blood cells will naturally gradually decline. For kidney patients with pure hematuria without proteinuria and abnormal renal function, doctors usually do not give drug treatment in most cases, but this does not mean that they should not be ignored. Pay attention to health. Lifestyle, infection prevention, and regular urinalysis, blood pressure, and kidney function checks are necessary for about 6 months.
Is a kidney biopsy necessary?
If it is diagnosed as IgA nephropathy, kidney biopsy must be performed.
But not all patients with suspected IgA nephropathy require renal puncture.
The doctor passed the patient’s typical clinical manifestations: young people, hematuria after a cold or Hematuria combined with proteinuria may be roughly speculated to be IgA nephropathy. Some patients with relatively mild disease who have achieved good curative effect through empirical treatment may not undergo renal puncture.
For patients whose urine protein is greater than 0.5-1g/day and the doctor thinks that renal puncture is necessary, also Don’t be shy about getting sick. Renal puncture has been used in nephrology for decades, and the technology is quite mature, and there will be no sequelae. → Kidney puncture 20 questions, forward to friends in need
Is it necessary to use hormones?
Not all patients with IgA nephropathy need to use hormones, and not all people use hormones well. If the patient has more pathologically active lesions in renal puncture, on the basis of adequate supportive treatment (sufficient RAS blocker, and active and effective blood pressure control) On the other hand, because the proteinuria cannot be effectively controlled, and considering that the patient is at high risk of renal disease progression, and the benefits of using hormones outweigh the disadvantages, doctors should consider hormones. Whether to use or not, each person’s clinical manifestations and pathological conditions are different. Find a professional doctor to weigh the pros and cons of using it.
When can I stop taking the medicine?
It is also different from person to person. Everyone should be soberly aware that IgA nephropathy is a chronic disease that cannot be cured. Management is not an overnight effort, take your time and don’t be so anxious. In early stage patients, our goal is to achieve clinical remission and control of proteinuria, blood pressure and other indicators, but clinical remission does not mean cure. Some patients who have achieved remission can try to gradually reduce the dose to stop the drug under the guidance of the doctor, while most patients may not be able to stop the drug and need one or two drugs such as RAS blockers for life to maintain the remission state, especially the initial urine protein. More than 1g, patients who achieve remission for a long time should not be in a hurry. Don’t always go to the doctor in pursuit of drug withdrawal. If you can maintain remission with some simple drugs, wouldn’t it be a victory? Apart from taking medicine and regular review, how different is it from ordinary people?
How can I avoid uremia?
The ideal treatment effect is not to completely eliminate hematuria and proteinuria, but to live in harmony with IgA nephropathy. The 24-hour urine protein should be controlled within 0.5g as much as possible, and the blood pressure should be controlled within < Within span>130/80mmHg, try to avoid nephrotoxic drugs in daily life. In terms of life, in order to continuously stabilize kidney function, we also need to pay attention to: A low-salt diet. Diversify the variety of food, and don’t eat indiscriminately; Encourage adherence to aerobic exercise instead of lying down all day. Stay up late, work and rest regularly. As long as your physique is good and your immunity is good, you won’t always have large and small infections coming to your door.
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For patients with chronic renal insufficiency, there will be more precautions, and attention should also be paid to issues such as anemia, acidosis, calcium and phosphorus disorders. In terms of diet, we should also pay attention to a high-quality low-protein diet. These are also often mentioned by our kidney line, so I won’t go into details here.
Finally, what Kidney Online wants to say is, Many people are very anxious after getting sick, the food is not fragrant, and the night Insomnia,this is a necessary process, allow yourself to be anxious for a while. But slowly, you still have to cheer up and learn how to protect yourself. When you really face your inner fears bravely, take care of yourself every day Food, life, and medication, fear will slowly turn into cherishing and gratitude for life. Some people enjoy all the glory and wealth, but they still suffer; Brown wears the knot, and the scoop is repeatedly empty. Kidney disease has not deprived us of life, we can still breathe and enjoy the sunshine every day, which is already the best gift of life.
Pay attention to kidney online and take care of kidney health! ☟☟
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