IgA Nephropathy
Presents with incidental finding of persistent microscopic hematuria or with an episode of macroscopic hematuria which is typically associated with concurrent upper respiratory infection or acute gastroenteritis– these episodes may be recurrent.
- May also present as persistent microscopic hematuria
- Proteinuria is usually less than 1000 mg/24 h
- Rare: Nephritic/nephrotic manifestation, facial edema, mild to moderate HTN, elevated creatinine, and blood urea nitrogen level (azotemia)
- Prognosis for childhood presentation is quite good, although 10–15% will develop proteinuria, hypertension with/without renal failure during long-term follow-up
Treatment
- Blood pressure control
- Alternate day of corticosteroids, if patient presents with overt nephritic syndrome with nephrotic-range proteinuria
- ACE inhibitors are effective in reducing proteinuria, combination of ACE inhibitors and angiotensin receptor blockers (caution: need to check renal function frequently due to synergistic reduction in GFR)
- Fish oil contains anti-inflammatory Omega 3, and was thought to protect from progression, but not evidence-based
