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      IgA Nephropathy: To Treat or Not to Treat?

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          Abstract

          IgA nephropathy (Berger’s disease) is thought to be the most common primary glomerulonephritis in the world. Characteristically, it presents with intermittent macroscopic hematuria in association with upper respiratory infections. The diagnosis is established by demonstrating predominant IgA deposits in the glomerular mesangium. One third of the cases progress slowly over 25 years to glomerulosclerosis and end-stage renal disease. This rate of disease progression has not been altered by any known treatment, including the use of corticosteroids or cyclosporine. The pathogenesis of this disease is unknown; however, recent data implicated oxygen free radicals in the development of IgA nephropathy. The recent controlled, double-blind, 2-year study from the Mayo Clinic showed that fish oil slowed the progression of IgA nephropathy. This contrasts with the previous studies where the use of fish oil either accelerated the rate of deterioration of renal function in patients with IgA nephropathy or showed no change compared to untreated subjects. Furthermore, in experimental uremia, marked renal functional deterioration with fish oil administration has been reported. Experimental models of IgA nephropathy have been developed in the past few years. In addition, molecular biology offers an unique opportunity to study kidney tissue obtained from patients and animals with IgA nephropathy. These advances will enable the identification of the critical sequence of events that result in renal injury and provide new insight into the pathogenesis and progression of IgA nephropathy. This will help clarify the role of free oxygen radical release on disease progression, and an understanding on the mechanisms of antioxidants, such as vitamin E, in preventing such renal injury.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1997
          1997
          19 December 2008
          : 75
          : 3
          : 251-258
          Affiliations
          aVirginia Commonwealth University’s Medical College of Virginia, Richmond, Va., bSchneider Children’s Hospital of Long Island Jewish Hospital, New Hyde Park, N.Y., cNorthwestern University and Children’s Memorial Hospital, Chicago, Ill., USA.; dVeterans General Hospital, Taipei, Taiwan, ROC
          Article
          189545 Nephron 1997;75:251–258
          10.1159/000189545
          9069444
          3e4fb075-3115-4a93-9273-087dbc019978
          © 1997 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 13 September 1996
          Page count
          Pages: 8
          Categories
          Pediatric Nephrology

          Cardiovascular Medicine,Nephrology
          IgA nephropathy,Berger’s disease,Glomerulonephritis,Vitamin E,Oxidant injury

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