Specific treatment for immunoglobulin a nephropathy
There is no known treatment that specifically modifies the presumed pathogenesis of immunoglobulin a nephropathy.
Nonimmune-modulating treatment with renin-angiotensin system blockade is still the best evidence-based intervention for slowing immunoglobulin a nephropathy progression.
The blood pressure target should be <125/75 to 130/80 mm Hg in adults and similar targets adjusted appropriately for body size and age in the pediatric population.
The aim should be to reduce the proteinuria to less than 500 to 1000 mg/day.
Angiotensin-converting enzyme inhibitors (ACEIs) or, alternatively, angiotensin receptor blockers (ARBs) should be initiated and titrated up to maximum doses as tolerated.
There is an increased risk of adverse events with combined use of these agents; thus it is generally inadvisable to combine them, especially with the limited evidence of benefit in the literature.
