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IgA Nephropathy

IgA Nephropathy is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Most common form of glomerulonephritis in the world
  • Renal parenchymal damage and dysfunction defined by deposition of IgA in glomerular mesangium
  • Significant contributor to the incidence of end-stage renal disease (ESRD) in parts of Asia

Epidemiology

Incidence
In patients who undergo renal biopsy, the following incidence was reported: 30–40% in Asia, 15–20% in Europe, and 5–10% in North America

Prevalence
  • Highest prevalence in Pacific Rim, particularly Japan and Korea
  • More common in Asians, whites, and American Indians versus blacks in the United States and Africa

Etiology and Pathophysiology

Genetics
  • Familial forms of IgA nephropathy (IgAN) exist with no specific gene identified.
  • IgA1 molecules deposit within the mesangium leading to an inflammatory reaction with eventual fibrosis and scarring of the nephron.

Risk Factors

  • Liver disease: Impaired removal of IgA by Kupffer cells in the liver predisposes individuals to IgA deposition in the kidney.
  • Celiac disease: Ingestion of gliadin results in the formation of IgA antigliadin antibodies and deposition of immune complexes in the kidney.

Commonly Associated Conditions

  • Henoch-Schönlein purpura
  • Hepatic failure
  • Celiac disease
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • Reiter syndrome
  • HIV
  • CMV

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Citation

Stephens, Mark B., et al., editors. "IgA Nephropathy." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. 5minute, www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117480/all/IgA_Nephropathy.
IgA Nephropathy. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117480/all/IgA_Nephropathy. Accessed June 18, 2019.
IgA Nephropathy. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117480/all/IgA_Nephropathy
IgA Nephropathy [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 June 18]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117480/all/IgA_Nephropathy.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - IgA Nephropathy ID - 117480 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117480/all/IgA_Nephropathy PB - Wolters Kluwer ET - 27 DB - 5minute DP - Unbound Medicine ER -