Proteinuria Mean Poor Prognosis for IgA Nephropathy

Proteinuria, as the typical symptom of kidney damage, has been shown to be an adverse prognostic factor in IgA Nephropahty. Even though symptom of proteinuria is of great significance for IgA Nephropathy patients, not every of them will necessarily has protein in urine.

IgA Nephropathy is an autoimmune disease which is marked by large amounts of IgA antibodies or IgA immune complexes in mesangial area. It is a primary glomerular disease, so in theory, it causes protein in urine easily. However, clinical investigation show that massive proteinuria in IgA Nephropathy is not as common as it is in many other kidney related diseases like FSGS.

In IgA Nephropathy, quantity of protein in urine, referring to severity of proteinuria symptom, is closely related with patient's prognosis. Generally speaking, patients with heavy or nephrotic range proteinuria have a lower renal survival than these with moderate or mild proteinuria. Thus, bringing proteinuria under control mean improving prognosis for IgA Nephropathy.

As proteinuria means so much for IgA Nephropathy. Controlling it to improve prognosis is very necessary:

Conventional treatment for proteinuria in IgA Nephropathy is prednison which has quick effects in stopping the increase of protein in urine. But unfortunately, its treatment effects are temporary and once patients stop taking medicines or reducing dose, disease relapse and even proteinuria becomes more serious.

In IgA Nephropathy, proteinuria appears because glomerular filtration membrane is damaged by inflammatory response which occurs only when there is too much immune complexes. In IgA Nephropathy, IgA antibodies or IgA immune complexes deposit in mesangial area, causing inflammatory response which damage glomerular filtration membrane directly. Damaged filtration membrane allows large protein leak out, as a consequence of which, protein occurs in urine. Thereby, the best method to control proteinuria symptom caused by IgA Nephropathy is to repair damaged filtration membrane.

Aside from repairing damaged filtration membrane, in daily life, IgA Nephropathy patients also need to limit protein intake, so as to avoid worsening kidney damages. In general, 0.6g of protein each day per kilogram body weight is enough.

Lastly, proteinuria is not an essential symptom in IgA Nephropathy, but restrict controlling of it contributes to a good prognosis for IgA Nephropathy patients.