The incidence of this kidney disease named after a person has been on the rise in recent years

　　■Qian Ying

　　Among all kinds of kidney diseases, most of them have Chinese names, such as membranous nephropathy, diabetic nephropathy, hypertensive nephropathy, etc. However, there is only one type of kidney disease that has only English names and personal names, which is IgA nephropathy.

　　In 1968, French doctors Berger and Hinglais first described and named it, so it is also called Berger's disease.

In my country, IgA nephropathy accounts for 40%-47.2% of primary glomerular diseases, and there has been a significant upward trend in recent years, and it is necessary to increase attention.

　　First of all, IgA nephropathy has a characteristic, the age of onset is low.

IgA nephropathy can occur at any age, but patients between the ages of 16 and 35 account for 80% of the total number of patients, and the incidence ratio of male to female is 2-6:1, with gender characteristics.

　　Secondly, the onset of this disease is very urgent, usually a few hours or 1-2 days after various infections, and some cases occur after strenuous exercise, and there will be visible hematuria suddenly, so it is also called "infected synchronous hematuria".

The infection that causes the disease can be an upper respiratory tract infection (covered with a cold, cough, etc.), or an intestinal and urinary tract infection.

　　Third, the clinical manifestations of this disease are relatively diverse. In addition to the most common episodic gross hematuria and asymptomatic hematuria, large amounts of proteinuria, malignant hypertension, acute renal failure, and chronic renal failure can also occur.

　　Fourth, this disease will occur in family clusters.

Familial IgA nephropathy means that at least 2 family members in a family of three generations have been diagnosed as IgA nephropathy by renal biopsy.

At present, it is generally believed that familial IgA nephropathy accounts for about 10% of all IgA nephropathy, and the proportion is not low. Therefore, it is very important and necessary to conduct family history investigation and urine screening history among relatives of patients with IgA nephropathy.

Patients with familial IgA nephropathy have a worse prognosis and are more likely to develop renal failure.

　　Fifth, another feature of this disease is the large difference in disease stage. 20% of IgA nephropathy can be clinically remitted after active treatment, 20% of IgA nephropathy progresses to end-stage renal failure after 10 years, and 30% of IgA nephropathy 20 Years later, it progresses to end-stage renal failure, and another 30% of IgA nephropathy presents with varying degrees of decline in renal function.

　　After understanding the characteristics of this disease, how is the treatment of IgA nephropathy progressing?

In fact, when the pathogenesis of IgA nephropathy is still unknown, there is no specific treatment method for the disease at present. The treatment is mainly based on different clinical manifestations.

　　[Recurrent gross hematuria]

　　The key is to actively search for and treat infectious lesions, such as tonsillitis, sinusitis, chronic enteritis, and urinary tract infections.

　　[Asymptomatic proteinuria, hematuria]

　　If the amount of proteinuria is less than 1 g/day, acei/arb can be used to control blood pressure and reduce proteinuria levels.

<p="">

　　【Large proteinuria or nephrotic syndrome type】

　　On the basis of ACEI/ARB control of blood pressure, hormones can be added, and immunosuppressive therapy can be combined if necessary.

　　[High blood pressure with renal insufficiency]

　　ACEI/ARB can be used as the main antihypertensive drugs to actively control blood pressure. When the renal function declines significantly, and the blood creatinine>265umo l/L, ACEI/ARB should be used with caution.

　　【Progressive】

　　Start immunosuppressive therapy as soon as possible, and strengthen immunosuppressive therapy if necessary.

　　In March, we ushered in the 16th World Kidney Day. During the disease day, various types of chronic kidney diseases, especially those secondary to diabetes, hypertension, and coronary heart disease, have occupied most of the publicity positions. Those suffering from these kidney diseases need to undergo regular kidney disease-related tests to achieve the purpose of early detection and early intervention, so as to maximize the prognosis of chronic kidney disease.

　　It is worth noting that IgA nephropathy is still one of the most important causes of various diseases originating in the kidneys. Popularization of disease knowledge of the disease allows the common people to see a doctor as soon as they develop symptoms, and the first time after a clear diagnosis Choose the right treatment at a time, cooperate with the doctors to carry out regular follow-ups as soon as the disease is relieved, and truly achieve "peaceful" with the kidney disease, and achieve the ultimate disease remission and delay the progress during the long-term medical follow-up. important.

If this knowledge is truly rooted in the hearts of the people, ordinary people can still have a better life even if they are diagnosed with kidney disease.

　　(The author is the deputy chief physician of the Nephrology Department of Ruijin Hospital, Shanghai Jiaotong University School of Medicine)