The Differences in Etiology and Treatment of IgA Nephropathy in Korea

  • Dong-Wan ChaeEmail author


IgA nephropathy (IgAN) is the most common primary glomerulonephritis affecting young persons, the incidence of which has increased recently in Korea. Many studies related to the etiology and the pathogenesis such as various biomarkers, gene polymorphism, and intrarenal expression of various cytokines and chemokines and proteomic studies have been performed in serum, urine, and renal tissues obtained from Korean patients with IgA nephropathy. The activation of alternative pathway of complements in systemic circulation as well as local mesangial area and the activation of lectin and classic pathway of complement in some subset of patients have been shown to contribute to renal damage in IgAN. Clinical utility of Oxford classification have been verified in Korean patients, but the significance of crescent in therapeutic response and prognosis remains to be defined especially in patients with low basal estimated glomerular filtration rate (eGFR) and/or patients on the immunosuppressive therapy at the time of renal biopsy. The maintenance of proteinuria <1 g/day as recommended by KDIGO was a reasonable therapeutic target in renal protection, but the attainment of proteinuria <0.3 g/day might provide additional renal protection especially in young and otherwise healthy patients in whom a long life span is expected. Renin-angiotensin system (RAS) blockades reduced proteinuria and improved the survival of patients as well as the kidney. Various regimens of corticosteroid treatments effectively reduced proteinuria and hematuria and induced the improvement or stabilization of renal function even in patients with already decreased eGFR before treatment. Treatments by calcineurin inhibitors and sulodexide in IgAN were also reported with some positive results.


IgA nephropathy Korea Pathogenesis Treatment 


Conflict of Interest

The author declares that he has no conflict of interest.


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© Springer Japan 2016

Authors and Affiliations

  1. 1.Division of NephrologySeoul National University Bundang Hospital, Department of Internal Medicine, Seoul National College of MedicineSeongnam-siSouth Korea

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