title: Treatment of IgA nephropathy: an update.
abstract: OBJECTIVE
  To review current literature regarding treatment options for immunoglobulin A nephropathy (IgAN).
  
  
  METHODS
  A MEDLINE search was performed using the terms IgA nephropathy, Berger's disease, immunoglobulin A nephropathy, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, fish oil, omega-3 fatty acids, statins, hydroxymethylglutaryl-CoA reductase inhibitors, immunosuppressive therapy, corticosteroids, mycophenolate mofetil, cyclophosphamide, cyclosporine, azathioprine, leflunomide, antiplatelets, anticoagulants, vitamin E, infliximab, calcitriol, and intravenous immunoglobulins. A date limit was not set; however, focus was on publications from 1999 to June 2011 to review recent literature and therapeutic recommendations.
  
  
  METHODS
  All articles in English, including studies conducted in humans, meta-analyses, review articles, guidelines, statements, and reference citations, were identified and evaluated.
  
  
  RESULTS
  IgAN is the most common primary glomerulonephritis worldwide, leading to end-stage renal disease in 20-30% of patients. Evidence guiding management of IgAN has been sparse and clinical trials have not conclusively demonstrated effective treatments, largely due to suboptimal methodologies. Treatment strategies have included management of blood pressure and lipids, improvement or stabilization of kidney function, and reduction of proteinuria. This review of IgAN provides an update regarding standard and nonconventional treatment options based on recently published literature.
  
  
  CONCLUSIONS
  Supportive therapies, including angiotensin blockade, should be considered as first-line therapy for patients with urine protein >0.5 g/day and/or blood pressure >140/90 mm Hg. Corticosteroids could be considered as add-on or monotherapy for patients with urine protein >1 g/day with preserved renal function. Conclusive data are lacking for general treatment recommendations for the use of other therapies for IgAN.
authors.affiliation: Pharmacy Practice, School of Pharmacy, Southern Illinois University Edwardsville, Edwardsville, IL, USA. jenieme@siue.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Rosselli
authors.forename: Stacey M
authors.initials: SM
authors.lastname: Thacker
authors.forename: Julie P
authors.initials: JP
authors.lastname: Karpinski
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Petkewicz
mesh_terms: D000809:Angiotensins / Q000037:antagonists & inhibitors; D000818:Animals; D003131:Combined Modality Therapy; D005922:Glomerulonephritis, IGA / Q000276:immunology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000517:prevention & control
chemical_list: D000809:Angiotensins