IgA Nephropathy

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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

-- To view the remaining sections of this topic, please or --

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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