IgA glomerulonephritis: beyond angiotensin-converting enzyme inhibitors.

Abstract

IgA glomerulonephritis accounts for 25-50% of renal biopsy diagnoses. About 25-50% of patients progress to end-stage renal disease within 20 years of diagnosis. Angiotensin-converting enzyme inhibitors and angiotensin II type I receptor blockers slow progression of IgA nephropathy (IgAN); however, as drugs of this class are not IgAN specific and are therefore unlikely to alter significantly its natural course, many other therapeutic approaches have been proposed. Most have been tested in a relatively small number of patients and have not yet proven to be effective in the long term. Conflicting and variable data, and a lack of long-term prospective randomized studies, mean that most treatments cannot be recommended as standard therapy for IgAN. Steroids seem to be the best treatment for patients with proteinuria, as drugs in this class ameliorate this symptom and protect against deterioration of renal function. Combined treatment with corticosteroids and cytotoxic drugs has yielded interesting results in several studies, especially in progressive patients with severe IgAN. In this review, we critically analyze the data on these treatments.

• Authors: Francesco Locatelli, Lucia Del Vecchio, Claudio Pozzi
• Journal: Nature clinical practice. Nephrology (Nat Clin Pract Nephrol) Vol. 2 Issue 1 Pg. 24-31 (Jan 2006) ISSN: 1745-8323 [Print] England
• PMID: 16932386 (Publication Type: Journal Article, Review)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Fish Oils
• Glucocorticoids
• Platelet Aggregation Inhibitors
• Dipyridamole

Topics

• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Dipyridamole (therapeutic use)
• Disease Progression
• Drug Therapy, Combination
• Fish Oils (therapeutic use)
• Glomerulonephritis, IGA (drug therapy, epidemiology)
• Glucocorticoids (therapeutic use)
• Humans
• Platelet Aggregation Inhibitors (therapeutic use)
• Proteinuria (epidemiology)
• Tonsillectomy
• Treatment Outcome