IgA nephropathy

Question 1

Nephritis refers to…

Answer 1

Inflammation within the nephrons of the kidneys (including glomeruli, tubules, interstitial tissue)

Question 2

What is nephritic syndrome?

Answer 2

Inflammation of the glomeruli. Often result of immune-mediated processes like post-infectious glomerulonephritis or systemic autoimmune diseases affecting kidneys.

Question 3

What are typical features of nephritic syndrome?

Answer 3

Haematuria
Proteinuria (lesser extent)
Renal impairment

Hypertension
Oedema
Oliguria

Question 4

What is nephrotic syndrome?

Answer 4

Renal disorder due to increased permeability of glomerular filtration barrier.

Question 5

What are typical features of nephrotic syndrome?

Answer 5

Proteinuria (greater extent)
Hypoalbuminaemia
Oedema
Hyperlipidaemia

Question 6

What is the most common cause of glomerulonephritis worldwide?

Answer 6

IgA nephropathy

Question 7

How does IgA classically present?

Answer 7

Macroscopic haematuria in young people following an upper respiratory infection

Question 8

IgA nephropathy is the most common cause of n____ syndrome

Answer 8

nephritic syndrome (inflammation of glomeruli)

Question 9

What is the other name for IgA nephropathy?

Answer 9

Berger’s syndrome

Question 10

What condition is IgA nephropathy associated with?

Answer 10

Henloch-Schonlein Purpura (IgA vasculitis)

Question 11

In IgA nephropathy, IgA complexes deposits in the m___ of the kidney causing inflammation

Answer 11

mesangium (region within glomerulus providing structural support to capillaries and helps regulate blood flow).

Question 12

What are IgA complexes?

Answer 12

IgA antibodies combine with antigens

Question 13

The presence of IgA complexes in the mesangium triggers an inflammatory response leading to i____ and d____ of the glomerullus

Answer 13

injury and damage

Question 14

What age group does IgA nephropathy usually present in?

Answer 14

Teens and young adults

Question 15

Some individuals with IgA nephropathy may progress to ___

Answer 15

CKD

Question 16

What is another common cause of nephritic syndrome (inflammation of nephron) other than IgA nephropathy?

Answer 16

Post streptococcal Glomerulonephritis

Question 17

What kind of infection commonly precedes IgA nephropathy?

Answer 17

Viral infection eg viral tonsillitis

Question 18

How long after viral infection (eg tonsillitis) does patient have visible haematuria in IgA nephropathy?

Answer 18

1-2 days after

Question 19

How do you diagnose IgA nephropathy?

Answer 19

Immunofluorescence microscopy: shows IgA complex deposition

(From renal biopsy)

Question 20

How do you differentiate between IgA nephropathy and Henoch-Schönlein purpura?

Answer 20

Both show positive IgA complex deposition however, IgA nephropathy is when IgA complexes only found in kidney. HSP is systemic so could also found in skin, liver)

Question 21

How do you treat IgA nephropathy?

Answer 21

Non curative and 30% progress to ESRF

Control blood pressure using ACE-inhibitor (1st line)

Can also give immunosuppressant medications like steroids to slow progression of the disease

Question 22

Where is there a greater incidence of IgA nephropathy?

Answer 22

Asian populations
(Also associated with HIV)

Question 23

Steroids can inhibit immune cell producing pro-inflammatory mediators like _____ to dampen inflammatory response

Answer 23

cytokines

Question 24

ACE-inhibitors help manage IgA by dampening the RAAS system and preventing angiotensin II to be made. Angiotensin II is a vaso______ of efferent arterioles in glomeruli and stimulates the release of aldosterone.
Therefore ACE-inhibitors promote vasodilation of the efferent arterioles leading to _____ intraglomerular pressure which protects them.

Answer 24

vasoconstrictor
decreased