Immunoglobulin A-nephropathy: modern view of the problem and treatment options

The presented review discusses the mechanisms of development, the issues of diagnosis and the possibility of therapy for IgAnephropathy. IgA-nephropathy is an immunocomplex lesion of the glomeruli, characterized by the predominant deposition of immunoglobulin A in the mesangia. IgA-nephropathy meets...

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Main Authors: I. T. Murkamilov, I. S. Sabirov, V. V. Fomin, Zh. A. Murkamilova
Format: Article
Language:Russian
Published: Open Systems Publication 2021-06-01
Series:Лечащий Врач
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Online Access:https://journal.lvrach.ru/jour/article/view/186
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author I. T. Murkamilov
I. S. Sabirov
V. V. Fomin
Zh. A. Murkamilova
author_facet I. T. Murkamilov
I. S. Sabirov
V. V. Fomin
Zh. A. Murkamilova
author_sort I. T. Murkamilov
collection DOAJ
description The presented review discusses the mechanisms of development, the issues of diagnosis and the possibility of therapy for IgAnephropathy. IgA-nephropathy is an immunocomplex lesion of the glomeruli, characterized by the predominant deposition of immunoglobulin A in the mesangia. IgA-nephropathy meets all the criteria of an immune-inflammatory disease and is a common type of chronic glomerulonephritis in all countries of the world. Changes in the molecular structure of IgA, disturbances in the processes of its glycosylation and polymerization, as well as the deposition of polymeric IgAl in the glomerular mesangium underlie the pathogenesis of the disease. There are primary, secondary, sporadic and familial forms of IgA-nephropathy. According to the clinical course, the classical, asymptomatic and atypical variants of the course of IgA-nephropathy are distinguished. Clinical manifestations of IgA-nephropathy consist of macro- or microhematuria, proteinuria and arterial hypertension. The final diagnosis is made with nephrobiopsy. Differential diagnosis is made between urolithiasis, renal tumor, secondary nephropathy, Alport syndrome, disease of thin basement membranes. In the treatment of IgA-nephropathy, blockers of the renin-angiotensin-aldosterone system are used; a positive effect of tonsillectomy is possible. Glucocorticoids and cytostatics are recommended for nephrotic proteinuria, rapid disease progression, or signs of renal activity on morphological examination. The prognosis is good, although approximately 40% of patients develop dialysis-dependent end-stage renal disease after 15 to 20 years.
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spelling doaj-art-99f58b6eec03424eb068b6d2ea5c83f12025-08-20T03:42:34ZrusOpen Systems PublicationЛечащий Врач1560-51752687-11812021-06-0109192410.26295/OS.2020.49.29.004185Immunoglobulin A-nephropathy: modern view of the problem and treatment optionsI. T. Murkamilov0I. S. Sabirov1V. V. Fomin2Zh. A. Murkamilova3I.K. Akhunbaev Kyrgyz state medical academy; Kyrgyz-Russian Slavic University named after the first President of Russia B. N. YeltsinKyrgyz-Russian Slavic University named after the first President of Russia B. N. YeltsinN. I. Sechenov First Moscow State Medical UniversityKyrgyz-Russian Slavic University named after the first President of Russia B. N. YeltsinThe presented review discusses the mechanisms of development, the issues of diagnosis and the possibility of therapy for IgAnephropathy. IgA-nephropathy is an immunocomplex lesion of the glomeruli, characterized by the predominant deposition of immunoglobulin A in the mesangia. IgA-nephropathy meets all the criteria of an immune-inflammatory disease and is a common type of chronic glomerulonephritis in all countries of the world. Changes in the molecular structure of IgA, disturbances in the processes of its glycosylation and polymerization, as well as the deposition of polymeric IgAl in the glomerular mesangium underlie the pathogenesis of the disease. There are primary, secondary, sporadic and familial forms of IgA-nephropathy. According to the clinical course, the classical, asymptomatic and atypical variants of the course of IgA-nephropathy are distinguished. Clinical manifestations of IgA-nephropathy consist of macro- or microhematuria, proteinuria and arterial hypertension. The final diagnosis is made with nephrobiopsy. Differential diagnosis is made between urolithiasis, renal tumor, secondary nephropathy, Alport syndrome, disease of thin basement membranes. In the treatment of IgA-nephropathy, blockers of the renin-angiotensin-aldosterone system are used; a positive effect of tonsillectomy is possible. Glucocorticoids and cytostatics are recommended for nephrotic proteinuria, rapid disease progression, or signs of renal activity on morphological examination. The prognosis is good, although approximately 40% of patients develop dialysis-dependent end-stage renal disease after 15 to 20 years.https://journal.lvrach.ru/jour/article/view/186iga-nephropathyigagenetic predispositionhematuriaproteinuriaglomerular filtration rate
spellingShingle I. T. Murkamilov
I. S. Sabirov
V. V. Fomin
Zh. A. Murkamilova
Immunoglobulin A-nephropathy: modern view of the problem and treatment options
Лечащий Врач
iga-nephropathy
iga
genetic predisposition
hematuria
proteinuria
glomerular filtration rate
title Immunoglobulin A-nephropathy: modern view of the problem and treatment options
title_full Immunoglobulin A-nephropathy: modern view of the problem and treatment options
title_fullStr Immunoglobulin A-nephropathy: modern view of the problem and treatment options
title_full_unstemmed Immunoglobulin A-nephropathy: modern view of the problem and treatment options
title_short Immunoglobulin A-nephropathy: modern view of the problem and treatment options
title_sort immunoglobulin a nephropathy modern view of the problem and treatment options
topic iga-nephropathy
iga
genetic predisposition
hematuria
proteinuria
glomerular filtration rate
url https://journal.lvrach.ru/jour/article/view/186
work_keys_str_mv AT itmurkamilov immunoglobulinanephropathymodernviewoftheproblemandtreatmentoptions
AT issabirov immunoglobulinanephropathymodernviewoftheproblemandtreatmentoptions
AT vvfomin immunoglobulinanephropathymodernviewoftheproblemandtreatmentoptions
AT zhamurkamilova immunoglobulinanephropathymodernviewoftheproblemandtreatmentoptions