No Special Treatment Needed

IgA nephropathy patients with normal kidney function may not need special treatment

(RxWiki News) Patients with a common kidney disease often need special treatment to protect against kidney failure and other complications. But new research suggests certain patients may do just fine without special treatment.

Patients with a kidney disease called IgA nephropathy may not need special treatment if they have normal kidney function and only minor urinary problems when diagnosed.

"Many patients with IgA nephropathy have good prognosis."

People develop IgA nephropathy when certain proteins build up in the kidneys. This build-up can make the kidneys leak blood and proteins in the urine. In some cases, patients develop kidney failure, which requires dialysis or transplant.

In their study, Eduardo Gutiérrez, MD, of Hospital 12 de Octubre in Madrid, and colleagues set out to better understand the outcomes of patients who had normal kidney function, little or no urinary problems, and who were not taking immunosuppressive drugs when they were diagnosed with IgA nephropathy.

The researchers found that many of these patients experienced remission (lessening of disease symptoms) without any special treatments other than those needed to lower blood pressure or control proteinuria (leakage of proteins in the urine).

None of these patients developed kidney failure over the course of 20 years.

These findings suggest that certain patients with IgA nephropathy may have excellent outcomes and may not need to take toxic immunosuppressive drugs.

According to Dr. Gutiérrez, the results of this study are important because past studies have suggested that IgA nephropathy is a progressive disease (gets worse over time) even in these patients who are diagnosed with better kidney function.

The study included 141 Caucasian patients with IgA nephropathy who had normal kidney function and little or no proteinuria when diagnosed. None of the participants were being treated with steroids or immunosuppressive drugs.

After 10 years, 96.7 percent of patients kept their blood creatinine levels from increasing by 50 percent. Increases in blood creatinine are a sign of worsening kidney function.

After 20 years, 91.9 percent of patients kept blood creatinine levels from increasing by 50 percent.

A total of 53 patients (37.5 percent) experienced remission after about 4 years.

Another 41 patients (29.1 percent) had no proteinuria.

While 23 patients (16.3 percent) started the study with high blood pressure, 30 patients (21.3 percent) ended the study with high blood pressure.

A total of 59 patients (41.8 percent) received drugs to treat high blood pressure and proteinuria.

The study was published September 6 in the Journal of the American Society of Nephrology.

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Review Date: 
September 24, 2012