IgA nephropathy Flashcards
Nephritis refers to…
Inflammation within the nephrons of the kidneys (including glomeruli, tubules, interstitial tissue)
What is nephritic syndrome?
Inflammation of the glomeruli. Often result of immune-mediated processes like post-infectious glomerulonephritis or systemic autoimmune diseases affecting kidneys.
What are typical features of nephritic syndrome?
Haematuria
Proteinuria (lesser extent)
Renal impairment
Hypertension
Oedema
Oliguria
What is nephrotic syndrome?
Renal disorder due to increased permeability of glomerular filtration barrier.
What are typical features of nephrotic syndrome?
Proteinuria (greater extent)
Hypoalbuminaemia
Oedema
Hyperlipidaemia
What is the most common cause of glomerulonephritis worldwide?
IgA nephropathy
How does IgA classically present?
Macroscopic haematuria in young people following an upper respiratory infection
IgA nephropathy is the most common cause of n____ syndrome
nephritic syndrome (inflammation of glomeruli)
What is the other name for IgA nephropathy?
Berger’s syndrome
What condition is IgA nephropathy associated with?
Henloch-Schonlein Purpura (IgA vasculitis)
In IgA nephropathy, IgA complexes deposits in the m___ of the kidney causing inflammation
mesangium (region within glomerulus providing structural support to capillaries and helps regulate blood flow).
What are IgA complexes?
IgA antibodies combine with antigens
The presence of IgA complexes in the mesangium triggers an inflammatory response leading to i____ and d____ of the glomerullus
injury and damage
What age group does IgA nephropathy usually present in?
Teens and young adults
Some individuals with IgA nephropathy may progress to ___
CKD
What is another common cause of nephritic syndrome (inflammation of nephron) other than IgA nephropathy?
Post streptococcal Glomerulonephritis
What kind of infection commonly precedes IgA nephropathy?
Viral infection eg viral tonsillitis
How long after viral infection (eg tonsillitis) does patient have visible haematuria in IgA nephropathy?
1-2 days after
How do you diagnose IgA nephropathy?
Immunofluorescence microscopy: shows IgA complex deposition
(From renal biopsy)
How do you differentiate between IgA nephropathy and Henoch-Schönlein purpura?
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)
How do you treat IgA nephropathy?
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
Where is there a greater incidence of IgA nephropathy?
Asian populations
(Also associated with HIV)
Steroids can inhibit immune cell producing pro-inflammatory mediators like _____ to dampen inflammatory response
cytokines
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.
vasoconstrictor
decreased
