Pediatric IgA Nephropathy Follow-up

  • Author: Mohammad Ilyas, MD, FAAP; Chief Editor: Craig B Langman, MD   more...
 
Updated: Aug 3, 2010
 

Further Inpatient Care

Inpatient care is not necessary in patients with immunoglobulin A (IgA) nephropathy (IgAN), except for complications of renal failure, hypertension, dialysis, or renal transplantation.

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Further Outpatient Care

Routine follow up is important for monitoring the progression of disease.

Medications must be taken as prescribed.

A healthy diet and lifestyle is important.

Patients should avoid obesity, smoking, and other activities that negatively influence the cardiovascular system.

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Inpatient & Outpatient Medications

No specific change of medication is necessary to transition from inpatient to outpatient therapy.

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Transfer

No transfer is necessary.

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Deterrence/Prevention

No methods for deterrence or prevention of IgA nephropathy are known.

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Complications

Primary complications include those related to uncontrolled hypertension (eg, seizure, stroke, end-organ damage), renal insufficiency (eg, growth failure, bone demineralization, anemia), and adverse reactions to one of the prescribed medications.

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Prognosis

IgA nephropathy may follow a variable course, ranging from benign throughout childhood to rapidly progressive renal failure.

Children with renal failure require dialysis and/or transplantation, but the prognosis for long-term survival is very good.

The severity of pathology on renal biopsy, increased serum creatinine levels at diagnosis, and younger age are significant independent predictors of renal failure.[18]

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Patient Education

Inform patients about specific disease processes when possible.

Encourage patients to avoid risk factors, such as smoking, drugs, obesity, and poor medication compliance.

For excellent patient education resources, visit eMedicine's Kidneys and Urinary System Center. Also, see eMedicine's patient education article Blood in the Urine.

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Contributor Information and Disclosures
Author

Mohammad Ilyas, MD, FAAP  Assistant Professor of Pediatrics, University of Florida College of Medicine; Consulting Staff, Department of Pediatrics, Section of Nephrology, Wolfson Children Hospital and Shands Hospital Jacksonville

Mohammad Ilyas, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics and American Society of Nephrology

Disclosure: Nothing to disclose.

Coauthor(s)

Richard Neiberger, MD, PhD  Director of Pediatric Renal Stone Disease Clinic, Associate Professor, Department of Pediatrics, Division of Nephrology, University of Florida College of Medicine and Shands Hospital

Richard Neiberger, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Federation for Medical Research, American Medical Association, American Society of Nephrology, American Society of Pediatric Nephrology, Christian Medical & Dental Society, Florida Medical Association, International Society for Peritoneal Dialysis, International Society of Nephrology, National Kidney Foundation, New York Academy of Sciences, Shock Society, Sigma Xi, Southern Medical Association, Southern Society for Pediatric Research, and Southwest Pediatric Nephrology Study Group

Disclosure: The Osler Institute Honoraria Speaking and teaching

Specialty Editor Board

Deogracias Pena, MD  Medical Director of Dialysis, Department of Pediatrics, Cook Children's Medical Center; Clinical Associate Professor, Texas Tech University School of Medicine

Deogracias Pena, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and American Society of Pediatric Nephrology

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Adrian Spitzer, MD  Professor, Department of Pediatrics, Albert Einstein College of Medicine; Director of NIH Training Program, Children's Hospital at Montefiore Medical Center

Adrian Spitzer, MD is a member of the following medical societies: American Academy of Pediatrics, American Federation for Medical Research, American Pediatric Society, American Society of Nephrology, American Society of Pediatric Nephrology, International Society of Nephrology, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Howard Trachtman, MD  Program Director, Pediatrics Research, Schneider Children's Hospital, Department of Pediatrics, Division of Nephrology, Professor, Albert Einstein College of Medicine

Howard Trachtman, MD is a member of the following medical societies: American Society of Hypertension, American Society of Nephrology, American Society of Pediatric Nephrology, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Craig B Langman, MD  The Isaac A Abt, MD, Professor of Kidney Diseases, Feinberg School of Medicine, Northwestern University; Division Head of Kidney Diseases, Children's Memorial Hospital, Chicago

Craig B Langman, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Nephrology, and International Society of Nephrology

Disclosure: Merck Grant/research funds None; NIH Grant/research funds None; Raptor Pharmaceuticals, Inc Grant/research funds None; Alexion Pharmaceuticals, Inc. Grant/research funds None

References

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  2. [Best Evidence] Li LS; Liu ZH. Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. Kidney Int. Sep 2004;66(3):920-3. [Medline].

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Glomerulus with mesangial hypercellularity and intact capillary loops. Trichrome Stain, original magnification 400x. Image courtesy of Patrick D Walker, MD.
Mesangial deposits of immunoglobulin A (IgA). Fluoresceinated Anti-IgA Antibody, Immunofluorescence microscopy, original magnification 400x. Image courtesy of Patrick D Walker, MD.
Electron photomicrograph showing mesangial electron dense deposits (arrow). Uranyl acetate and lead citrate stain, original magnification 12,000x. Image courtesy of Patrick D Walker, MD.
 
 
 
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