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The Treatment of IgA Nephropathy

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IgA Nephropathy

Part of the book series: Topics in Renal Medicine ((TIRM,volume 2))

Abstract

Overt clinical features of IgA nephropathy0 frequently resolve spontaneously and the disease may remain quiescent clinically for months or years. As such, episodes of macroscopic hematuria and evanescent decline in renal function are probably not reliable indices of long-term disease activity whereby the effects of treatment may be gauged. Urinary abnormalities, particularly microscopic hematuria, persist in the majority of patients, however, and many develop gradually increasing proteinuria and hypertension. It is the policy of our unit to monitor these features and serial measurements of renal function to assess progress. It has become clear, however, from study of repeat renal biopsies, that such monitoring does not reflect accurately the changes occurring in kidney morphology. Although there is a loose association between disease progression as assessed by decline of renal function, proteinuria and hypertension with glomerular sclerosis, interstitial scarring and vascular changes, these features are often present in biopsies from patients with no symptoms. By contrast, it is not unusual to discover rather bland changes of mesangial proliferative glomerulonephritis in patients with overt symptoms.

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References

  1. Clarkson AR, Woodroffe AJ: Therapeutic perspectives in mesangial IgA nephropathy. Contrib Nephrol 40:187–194, 1984.

    PubMed  CAS  Google Scholar 

  2. Nagy J, Uj M, Szuks G, Trinn CS, Burger J: Herpes virus antigens and antibodies in kidney biopsies and sera of IgA glomerulonephritic patients. Clin Nephrol 21:259–263, 1984.

    PubMed  CAS  Google Scholar 

  3. Woodroffe AJ, Goormly AA, Menzie PE, Wootton AM, Thompson AJ, Seymour AE, Clarkson AR: Immunologic studies in IgA nephropathy. Kidney Int 18:366–374, 1980.

    Article  PubMed  CAS  Google Scholar 

  4. Kincaid-Smith PS, Nicholls K: Mesangial IgA nephropathy. Am J Kidney Dis 3:90–102, 1983.

    PubMed  CAS  Google Scholar 

  5. Worthington BS, Meserole L, Syrotuck JA: Effects of daily ethanol ingestion on intestinal permeability to macromolecules. Dig Dis 28:23–32, 1978.

    Google Scholar 

  6. Lagrue G, Sadreux T, Laurent J, Hirbec G: Is there a treatment for IgA glomerulonephritis? Clin Nephrol 14:161, 1980.

    Google Scholar 

  7. Sorrel TC, Forbes IJ, Burness FR, Rishbieth RHC: Depression of immunological function in patients treated with phenytoin sodium (sodium diphenylhydantoin). Lancet 2:1233–1235, 1971.

    Article  Google Scholar 

  8. Grob PJ, Herold, GE: Immunological abnormalities and hydantoins, Br Med J 2:561–563, 1972.

    Article  PubMed  CAS  Google Scholar 

  9. Sorrel TC, Forbes IJ: Depression of immune competence by phenytoin and carbemazepine: studies in vivo and in vitro. Clin Exp Immunol 20:273–279, 1975.

    Google Scholar 

  10. Seager J, Wilson J, Jamison DL, Hayward AR, Soothill JC: IgA deficiency, epilepsy and phenytoin treatment. Lancet 2:632–635, 1975.

    Article  PubMed  CAS  Google Scholar 

  11. Aarli JA, Tonder O: Effect of anti-epileptic drugs on serum and salivary IgA. Scand J Immunol 4:391–391, 1975.

    Article  PubMed  CAS  Google Scholar 

  12. Fontana A, Sauter R, Grob PJ, Joller H: IgA deficiency, epilepsy and hydantoin medication. Lancet 2:228–231, 1976.

    Article  PubMed  CAS  Google Scholar 

  13. Clarkson AR, Seymour AE, Woodroffe AJ, Menzie PE, Chan Y-L, Wootton AM: Controlled trial of phenytoin therapy in IgA nephropathy. Clin Nephrol 13:215–218, 1980.

    PubMed  CAS  Google Scholar 

  14. Coppo R, Basolo B, Bulzomi MR, Piccoli G: Ineffectiveness of phenytoin treatment on IgA-containing circulating immune complexes in IgA nephropathy. Nephron 36:275–276, 1984.

    Article  PubMed  CAS  Google Scholar 

  15. Lopez-Trascasca M, Egido J, Sancho J, Hernando L: Evidence of high polymeric IgA levels in serum of patients with Berger’s disease and its modification with phenytoin treatment. Proc Eur Dial Transplant Assoc 16:513, 1979.

    Google Scholar 

  16. Menzie PE, Taylor AE, Woodroffe AJ, Seymour AE, Chan Y-L, Clarkson AR: Plasmapheresis in glomerulonephritis. Clin Nephrol 12:97–108, 1979.

    Google Scholar 

  17. Hene RJ, Kater L: Plasmapheresis in nephritis associated with Henoch-Schönlein purpura and in primary IgA nephropathy. Plasma Ther Transfus Technol 4:165–173, 1983.

    Google Scholar 

  18. Kauffmann RH, Hourwert DA: Plasmapheresis in rapidly progressive Henoch-Schönlein glomerulonephritis and the effect on circulating IgA immune complexes. Clin Nephrol 16:155–160, 1981.

    PubMed  CAS  Google Scholar 

  19. Bannister KM, Drew PA, Clarkson AR, Woodroffe AJ: Immunoregulation in glomerulonephritis, Henoch-Schönlein purpura and lupus nephritis. Clin Exp Immunol 53:384–390, 1983.

    PubMed  CAS  Google Scholar 

  20. Coppo R, Basolo B, Giachino O, Rocatelli D, Lajola D, Mazzucco G, Amore A, Piccoli G: Plasmapheresis in a patient with rapidly progressive idiopathic IgA nephropathy: removal of IgA-containing immune complexes and clinical recovery. Nephron 40:488–490, 1985.

    Article  PubMed  CAS  Google Scholar 

  21. Nicholls K, Kincaid-Smith P: Defective in vivo Fc- and C3b-receptor function in IgA nephropathy. Am J Kidney Dis 4:128–134, 1984.

    PubMed  CAS  Google Scholar 

  22. Tomino Y, Sakai H, Suga T, Kaneshige H, Endoh M, Nomoto Y: Impaired solubilization of tissue-deposited immune-complexes by sera from patients with IgA nephropathy. Am J Kidney Dis 3:48–54, 1983.

    PubMed  CAS  Google Scholar 

  23. Tomino Y, Sakai H, Miura M, Suga T, Endoh M, Nomoto Y: Effect of Danazol on solubilization of immune deposition in patients with IgA nephropathy. Am J Kidney Dis 4:135–140, 1984.

    PubMed  CAS  Google Scholar 

  24. Hamazaki T, Tateno S, Shishedo H: Eicosapentanoic acid and IgA nephropathy. Lancet 1:1017–1018, 1984.

    Article  PubMed  CAS  Google Scholar 

  25. Prickett JD, Robinson DR, Steinberg AD: Effects of dietary enrichment with eicosapentanoic acid upon auto-immune nephritis in female NZB/NZW Ft mice. Arthritis Rheum 26:133–139, 1983.

    Article  PubMed  CAS  Google Scholar 

  26. Dyerberg J, Bang, HD: Atherogenesis and haemostasis in Eskimos: the role of the prostaglandin-3 family. Haemostasis 8:227–233, 1979.

    PubMed  CAS  Google Scholar 

  27. Sanders TAB, Roshanai F: The influence of different types of W-3 polyunsaturated fatty acids on blood lipids and platelet function in healthy volunteers. Clin Sci 64:91–99, 1983.

    PubMed  CAS  Google Scholar 

  28. Hay CRM, Durber AP, Saynor R: Effects of fish oil on platelet kinetics in patients with ischaemic heart disease. Lancet 1:1269–1272, 1982.

    Article  PubMed  CAS  Google Scholar 

  29. Michael AF: The glomerular mesangium. Contrib Nephrol 40:7–18, 1984.

    PubMed  CAS  Google Scholar 

  30. Kreisberg JI, Karnovsky MJ, Levine L: Prostaglandin production by homogeneous cultures of rat glomerular epithelial and mesangial cells. Kidney Int 22:355–359, 1982.

    Article  PubMed  CAS  Google Scholar 

  31. Hollenberg NK: Angiotensin-Converting enzymeinhibition: renal aspects. J Cardiovasc Pharmacol 7:540–544, 1985.

    Article  Google Scholar 

  32. Deleraissy J-F, Galanaud P, Balavoine J-F, Wallon C, Dormont J: Captopril and immune regulation. Kideny Int 25:925–929, 1984.

    Article  Google Scholar 

  33. Brenner BM, Meyer TW, Hotstetter TH: Dietary protein intake and the progressive nature of kidney disease: the role of haemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal abaltion and intrinsic renal disease. N Engl J Med 307:652–659, 1982.

    Article  PubMed  CAS  Google Scholar 

  34. Clarkson AR, Seymour AE, Thompson AJ, Haynes WDG, Chan Y-L, Jackson B: IgA nephropathy: a syndrome of uniform morphology, diverse clinical features and uncertain prognosis. Clin Nephrol 8:459–471, 1977.

    PubMed  CAS  Google Scholar 

  35. Kincaid-Smith P, Bennett WM, Dowling JP, Ryan GB: Acute renal failure and tubular necrosis assoicated with haematuria due to glomerulonephritis. Clin Nephrol 19:206–210, 1983.

    PubMed  CAS  Google Scholar 

  36. Clarkson AR, Seymour AE, Chan Y-L, Thompson AJ, Woodroffe AJ: Clinical, pathological and therapeutic aspects of IgA nephropathy. In: P. Kincaid-Smith. A. D’Apice, R. Atkins (eds) Progress in glomerulonephritis New York: John Wiley and Sons, 1979, pp 247–160.

    Google Scholar 

  37. Berger J, Yaneva H, Nabarra B, Barbanel C: Recurrence of mesangial deposition of IgA after renal transplantation. Kidney Int 1:232–241, 1975.

    Article  Google Scholar 

  38. Mathew TH, Mathews DC, Hobbs, JB, Kincaid-Smith P: Glomerular lesions after renal transplatation. Am J Med 7:177–190, 1975.

    Article  Google Scholar 

  39. Morzycka M, Croker BP, Siegler HF, Tisher CC: Evaluation of recurrent glomerulonephritis in kidney allografts. Am J Med 72:588–598, 1982.

    Article  PubMed  CAS  Google Scholar 

  40. Siegler HF, Ward FE, Maoy RE, WeinertL, Gunnels JC, Stickel DL: Long-term results with forty-five living-related renal allograft recipients genetically identical for HLA. Surgery 81:274–283, 1977.

    Google Scholar 

  41. Levy M, Moussa RA, Habib R, Gagnadoux MF, Broyer M: Anaphylactoid purpura nephritis and transplantation. Kidney Int 22:326, 1982.

    Google Scholar 

  42. Baliah T, Kim KH, Anthone S, Anthone R, Montes M, Andres GA: Recurrence of Henoch-Schönlein purpura glomerulonephritis in transplanted kidneys. Transplantation 18:343–346, 1974.

    Article  PubMed  CAS  Google Scholar 

  43. Berger J, Noel LH, Nabarra B: Recurrence of mesangial IgA nephropathy after renal transplantation. Contrib Nephrol 40:195–197, 1984.

    PubMed  CAS  Google Scholar 

  44. Le Savre P, Digeon M, Bach JF: Analysis of circulating IgA and detection of immune complexes in primary I nephropathy. Clin Exp Immunol 48:61–69, 1982.

    Google Scholar 

  45. Silva FG, Ghanda P, Priani CL, Hardy KA: Disappearance of glomerular mesangial IgA deposits after renal allograft transplantation. Transplantation 33:214–216, 1982.

    Article  Google Scholar 

  46. Sanfilippo F, Croker BP, Bollinger RR: Fate of four cadaveric renal allografts with mesangial IgA deposits. Transplantation 33:370–372, 1982.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Anthony R. Clarkson
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Anthony R. Clarkson

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© 1987 Martinus Nijhoff Publishing, Boston

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Clarkson, A.R. (1987). The Treatment of IgA Nephropathy. In: Clarkson, A.R. (eds) IgA Nephropathy. Topics in Renal Medicine, vol 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2039-5_15

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  • DOI: https://doi.org/10.1007/978-1-4613-2039-5_15

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9213-5

  • Online ISBN: 978-1-4613-2039-5

  • eBook Packages: Springer Book Archive

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