Skip to main content
Erschienen in:

28.11.2024 | IgA-Nephropathie | Leitthema

IgA-Nephropathie

verfasst von: Dr. med. Claudia Seikrit, Jürgen Floege, Prof. Dr. med.

Erschienen in: Die Nephrologie | Ausgabe 1/2025

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die IgA(Immunglobulin-A)-Nephropathie (IgAN) stellt weltweit die häufigste Form der Glomerulonephritis dar und zählt zu den Hauptursachen für Nierenversagen insbesondere bei jungen Erwachsenen. Sie hat einen individuell unterschiedlichen Verlauf, wobei die meisten der chronisch aktiven Verläufe die Entwicklung eines Nierenversagens voraussehen lassen. Es existieren keine gut definierten Prognosemarker, und das internationale IgAN Prediction Tool kann nur in den ersten 2 Jahren nach Sicherung der Diagnose herangezogen werden. Eine mögliche Dysregulation des mukosalen Immunsystems scheint Teil der Pathophysiologie zu sein, und TRF(„targeted-release formulation“)-Budesonid, ein Budesonid welches gezielt im Ileum freigesetzt wird, wurde aufgrund seiner überzeugenden Wirksamkeit als erstes speziell für die IgAN entwickeltes Medikament zugelassen. Neu ist nun auch die Behandlungsmöglichkeit mit Sparsentan, einem dualen Angiotensin-II- und Endothelin-A-Rezeptor-Antagonisten, welcher durch eine rasche Reduktion der Proteinurie überzeugt. Eine Vielzahl weiterer Therapieansätze ist Gegenstand klinischer Forschung.
Literatur
1.
Zurück zum Zitat Bischoff SC et al (2014) Intestinal permeability—a new target for disease prevention and therapy. BMC Gastroenterol 14:189PubMedPubMedCentral Bischoff SC et al (2014) Intestinal permeability—a new target for disease prevention and therapy. BMC Gastroenterol 14:189PubMedPubMedCentral
2.
Zurück zum Zitat McGrogan A, Franssen CF, de Vries CS (2011) The incidence of primary glomerulonephritis worldwide: a systematic review of the literature. Nephrol Dial Transplant 26(2):414–430PubMed McGrogan A, Franssen CF, de Vries CS (2011) The incidence of primary glomerulonephritis worldwide: a systematic review of the literature. Nephrol Dial Transplant 26(2):414–430PubMed
3.
Zurück zum Zitat Berthoux F et al (2011) Predicting the risk for dialysis or death in IgA nephropathy. J Am Soc Nephrol 22(4):752–761PubMedPubMedCentral Berthoux F et al (2011) Predicting the risk for dialysis or death in IgA nephropathy. J Am Soc Nephrol 22(4):752–761PubMedPubMedCentral
4.
5.
Zurück zum Zitat Cattran DC et al (2008) The impact of sex in primary glomerulonephritis. Nephrol Dial Transplant 23(7):2247–2253PubMed Cattran DC et al (2008) The impact of sex in primary glomerulonephritis. Nephrol Dial Transplant 23(7):2247–2253PubMed
6.
7.
Zurück zum Zitat Hiki Y et al (2001) Mass spectrometry proves under-O-glycosylation of glomerular IgA1 in IgA nephropathy. Kidney Int 59(3):1077–1085PubMed Hiki Y et al (2001) Mass spectrometry proves under-O-glycosylation of glomerular IgA1 in IgA nephropathy. Kidney Int 59(3):1077–1085PubMed
8.
Zurück zum Zitat Suzuki H et al (2008) IgA1-secreting cell lines from patients with IgA nephropathy produce aberrantly glycosylated IgA1. J Clin Invest 118(2):629–639PubMedPubMedCentral Suzuki H et al (2008) IgA1-secreting cell lines from patients with IgA nephropathy produce aberrantly glycosylated IgA1. J Clin Invest 118(2):629–639PubMedPubMedCentral
9.
Zurück zum Zitat Gharavi AG et al (2008) Aberrant IgA1 glycosylation is inherited in familial and sporadic IgA nephropathy. J Am Soc Nephrol 19(5):1008–1014PubMedPubMedCentral Gharavi AG et al (2008) Aberrant IgA1 glycosylation is inherited in familial and sporadic IgA nephropathy. J Am Soc Nephrol 19(5):1008–1014PubMedPubMedCentral
10.
Zurück zum Zitat Kiryluk K et al (2017) GWAS for serum galactose-deficient IgA1 implicates critical genes of the O‑glycosylation pathway. PLoS Genet 13(e1006609):2 Kiryluk K et al (2017) GWAS for serum galactose-deficient IgA1 implicates critical genes of the O‑glycosylation pathway. PLoS Genet 13(e1006609):2
11.
Zurück zum Zitat Kiryluk K et al (2023) Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy. Nat Genet 55(7):1091–1105PubMed Kiryluk K et al (2023) Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy. Nat Genet 55(7):1091–1105PubMed
12.
Zurück zum Zitat Floege J, Feehally J (2016) The mucosa-kidney axis in IgA nephropathy. Nat Rev Nephrol 12(3):147–156PubMed Floege J, Feehally J (2016) The mucosa-kidney axis in IgA nephropathy. Nat Rev Nephrol 12(3):147–156PubMed
13.
Zurück zum Zitat Zhai YL et al (2016) Increased APRIL Expression Induces IgA1 Aberrant Glycosylation in IgA Nephropathy. Medicine 95(e3099):11 Zhai YL et al (2016) Increased APRIL Expression Induces IgA1 Aberrant Glycosylation in IgA Nephropathy. Medicine 95(e3099):11
14.
Zurück zum Zitat Gleeson PJ et al (2024) The gut microbiota posttranslationally modifies IgA1 in autoimmune glomerulonephritis. Sci Transl Med 16(eadl6149):740 Gleeson PJ et al (2024) The gut microbiota posttranslationally modifies IgA1 in autoimmune glomerulonephritis. Sci Transl Med 16(eadl6149):740
15.
Zurück zum Zitat Rizk DV et al (2019) Glomerular Immunodeposits of Patients with IgA Nephropathy Are Enriched for IgG Autoantibodies Specific for Galactose-Deficient IgA1. J Am Soc Nephrol Rizk DV et al (2019) Glomerular Immunodeposits of Patients with IgA Nephropathy Are Enriched for IgG Autoantibodies Specific for Galactose-Deficient IgA1. J Am Soc Nephrol
16.
Zurück zum Zitat Suzuki H, Ig ANephropathy JN (2024) Significance of IgA1-Containing Immune Complexes in Clinical Settings. J Clin Med 13(15) Suzuki H, Ig ANephropathy JN (2024) Significance of IgA1-Containing Immune Complexes in Clinical Settings. J Clin Med 13(15)
17.
Zurück zum Zitat Xie M et al (2023) Predictive prognostic value of glomerular C3 deposition in IgA nephropathy. J Nephrol 36(2):495–505PubMed Xie M et al (2023) Predictive prognostic value of glomerular C3 deposition in IgA nephropathy. J Nephrol 36(2):495–505PubMed
18.
Zurück zum Zitat Anders HJ, Schlöndorff D (2007) Toll-like receptors: emerging concepts in kidney disease. Curr Opin Nephrol Hypertens 16(3):177–183PubMed Anders HJ, Schlöndorff D (2007) Toll-like receptors: emerging concepts in kidney disease. Curr Opin Nephrol Hypertens 16(3):177–183PubMed
19.
Zurück zum Zitat Lafayette R et al (2024) A phase 2b, randomized, double-blind, placebo-controlled, clinical trial of atacicept for treatment of IgA nephropathy. Kidney Int 105(6):1306–1315PubMed Lafayette R et al (2024) A phase 2b, randomized, double-blind, placebo-controlled, clinical trial of atacicept for treatment of IgA nephropathy. Kidney Int 105(6):1306–1315PubMed
20.
Zurück zum Zitat Mathur M et al (2022) Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of VIS649 (Sibeprenlimab), an APRIL-Neutralizing IgG(2) Monoclonal Antibody, in Healthy Volunteers. Kidney Int Rep 7(5):993–1003PubMedPubMedCentral Mathur M et al (2022) Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of VIS649 (Sibeprenlimab), an APRIL-Neutralizing IgG(2) Monoclonal Antibody, in Healthy Volunteers. Kidney Int Rep 7(5):993–1003PubMedPubMedCentral
21.
Zurück zum Zitat Rickert RC, Jellusova J, Miletic AV (2011) Signaling by the tumor necrosis factor receptor superfamily in B‑cell biology and disease. Immunol Rev 244(1):115–133PubMedPubMedCentral Rickert RC, Jellusova J, Miletic AV (2011) Signaling by the tumor necrosis factor receptor superfamily in B‑cell biology and disease. Immunol Rev 244(1):115–133PubMedPubMedCentral
22.
Zurück zum Zitat Grasset EK et al (2020) Gut T cell-independent IgA responses to commensal bacteria require engagement of the TACI receptor on B cells. Sci Immunol 5(49) Grasset EK et al (2020) Gut T cell-independent IgA responses to commensal bacteria require engagement of the TACI receptor on B cells. Sci Immunol 5(49)
23.
Zurück zum Zitat Lafayette R et al (2023) Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2‑year results from a randomised phase 3 trial. Lancet 402(10405):859–870PubMed Lafayette R et al (2023) Efficacy and safety of a targeted-release formulation of budesonide in patients with primary IgA nephropathy (NefIgArd): 2‑year results from a randomised phase 3 trial. Lancet 402(10405):859–870PubMed
24.
Zurück zum Zitat Wu D et al (2021) Mesangial C3 deposition and serum C3 levels predict renal outcome in IgA nephropathy. Clin Exp Nephrol 25(6):641–651PubMed Wu D et al (2021) Mesangial C3 deposition and serum C3 levels predict renal outcome in IgA nephropathy. Clin Exp Nephrol 25(6):641–651PubMed
25.
Zurück zum Zitat Poppelaars F et al (2021) The Contribution of Complement to the Pathogenesis of IgA Nephropathy: Are Complement-Targeted Therapies Moving from Rare Disorders to More Common Diseases? J Clin Med 10(20) Poppelaars F et al (2021) The Contribution of Complement to the Pathogenesis of IgA Nephropathy: Are Complement-Targeted Therapies Moving from Rare Disorders to More Common Diseases? J Clin Med 10(20)
26.
Zurück zum Zitat Gharavi AG et al (2011) Genome-wide association study identifies susceptibility loci for IgA nephropathy. Nat Genet 43(4):321–327PubMedPubMedCentral Gharavi AG et al (2011) Genome-wide association study identifies susceptibility loci for IgA nephropathy. Nat Genet 43(4):321–327PubMedPubMedCentral
27.
Zurück zum Zitat Guo W‑Y et al (2018) Coding and Noncoding Variants in CFH Act Synergistically for Complement Activation in Immunoglobulin A Nephropathy. Am J Med Sci 356(2):114–120PubMed Guo W‑Y et al (2018) Coding and Noncoding Variants in CFH Act Synergistically for Complement Activation in Immunoglobulin A Nephropathy. Am J Med Sci 356(2):114–120PubMed
28.
Zurück zum Zitat Guo WY et al (2021) Glomerular Complement Factor H‑Related Protein 5 is Associated with Histologic Injury in Immunoglobulin A Nephropathy. Kidney Int Rep 6(2):404–413PubMed Guo WY et al (2021) Glomerular Complement Factor H‑Related Protein 5 is Associated with Histologic Injury in Immunoglobulin A Nephropathy. Kidney Int Rep 6(2):404–413PubMed
29.
Zurück zum Zitat Medjeral-Thomas NR et al (2017) Circulating complement factor H-related proteins 1 and 5 correlate with disease activity in IgA nephropathy. Kidney Int 92(4):942–952PubMedPubMedCentral Medjeral-Thomas NR et al (2017) Circulating complement factor H-related proteins 1 and 5 correlate with disease activity in IgA nephropathy. Kidney Int 92(4):942–952PubMedPubMedCentral
30.
Zurück zum Zitat Medjeral-Thomas NR et al (2018) Progressive IgA Nephropathy Is Associated With Low Circulating Mannan-Binding Lectin-Associated Serine Protease‑3 (MASP-3) and Increased Glomerular Factor H‑Related Protein‑5 (FHR5) Deposition. Kidney Int Rep 3(2):426–438PubMed Medjeral-Thomas NR et al (2018) Progressive IgA Nephropathy Is Associated With Low Circulating Mannan-Binding Lectin-Associated Serine Protease‑3 (MASP-3) and Increased Glomerular Factor H‑Related Protein‑5 (FHR5) Deposition. Kidney Int Rep 3(2):426–438PubMed
31.
Zurück zum Zitat Zhang H et al (2024) Results of a randomized double-blind placebo-controlled Phase 2 study propose iptacopan as an alternative complement pathway inhibitor for IgA nephropathy. Kidney Int 105(1):189–199PubMed Zhang H et al (2024) Results of a randomized double-blind placebo-controlled Phase 2 study propose iptacopan as an alternative complement pathway inhibitor for IgA nephropathy. Kidney Int 105(1):189–199PubMed
32.
Zurück zum Zitat Kohan DE et al (2023) Targeting the Endothelin A Receptor in IgA Nephropathy. Kidney Int Rep 8(11):2198–2210PubMedPubMedCentral Kohan DE et al (2023) Targeting the Endothelin A Receptor in IgA Nephropathy. Kidney Int Rep 8(11):2198–2210PubMedPubMedCentral
33.
Zurück zum Zitat Ivković V, Bruchfeld A (2024) Endothelin receptor antagonists in diabetic and non-diabetic chronic kidney disease. Clin Kidney J 17(sfae072):4 Ivković V, Bruchfeld A (2024) Endothelin receptor antagonists in diabetic and non-diabetic chronic kidney disease. Clin Kidney J 17(sfae072):4
34.
Zurück zum Zitat Martínez-Díaz I et al (2023) Endothelin Receptor Antagonists in Kidney Disease. Int J Mol Sci 24(4) Martínez-Díaz I et al (2023) Endothelin Receptor Antagonists in Kidney Disease. Int J Mol Sci 24(4)
35.
36.
Zurück zum Zitat Roberts IS et al (2009) The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. Kidney Int 76(5):546–556PubMed Roberts IS et al (2009) The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. Kidney Int 76(5):546–556PubMed
37.
Zurück zum Zitat Trimarchi H et al (2017) Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int 91(5):1014–1021PubMed Trimarchi H et al (2017) Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int 91(5):1014–1021PubMed
38.
Zurück zum Zitat Coppo R et al (2014) Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments. Kidney Int 86(4):828–836PubMedPubMedCentral Coppo R et al (2014) Validation of the Oxford classification of IgA nephropathy in cohorts with different presentations and treatments. Kidney Int 86(4):828–836PubMedPubMedCentral
39.
Zurück zum Zitat Barbour SJ et al (2022) Application of the International IgA Nephropathy Prediction Tool one or two years post-biopsy. Kidney Int 102(1):160–172PubMed Barbour SJ et al (2022) Application of the International IgA Nephropathy Prediction Tool one or two years post-biopsy. Kidney Int 102(1):160–172PubMed
40.
Zurück zum Zitat Haaskjold YL et al (2023) Validation of two IgA nephropathy risk-prediction tools using a cohort with a long follow-up. Nephrol Dial Transplant 38(5):1183–1191PubMed Haaskjold YL et al (2023) Validation of two IgA nephropathy risk-prediction tools using a cohort with a long follow-up. Nephrol Dial Transplant 38(5):1183–1191PubMed
41.
Zurück zum Zitat Barbour SJ et al (2024) Application of the updated International IgA Nephropathy Prediction Tool in children one or two years post-biopsy. Kidney Int Barbour SJ et al (2024) Application of the updated International IgA Nephropathy Prediction Tool in children one or two years post-biopsy. Kidney Int
42.
Zurück zum Zitat Thompson A et al (2019) Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy. Clin J Am Soc Nephrol 14(3):469–481PubMedPubMedCentral Thompson A et al (2019) Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy. Clin J Am Soc Nephrol 14(3):469–481PubMedPubMedCentral
43.
Zurück zum Zitat Inker LA et al (2016) Early Change in Urine Protein as a Surrogate End Point in Studies of IgA Nephropathy: An Individual-Patient Meta-analysis. Am J Kidney Dis 68(3):392–401PubMed Inker LA et al (2016) Early Change in Urine Protein as a Surrogate End Point in Studies of IgA Nephropathy: An Individual-Patient Meta-analysis. Am J Kidney Dis 68(3):392–401PubMed
44.
Zurück zum Zitat Anders HJ et al (2023) CKD therapy to improve outcomes of immune-mediated glomerular diseases. Nephrol Dial Transplant 38(2):ii50–ii57PubMed Anders HJ et al (2023) CKD therapy to improve outcomes of immune-mediated glomerular diseases. Nephrol Dial Transplant 38(2):ii50–ii57PubMed
45.
Zurück zum Zitat KDIGO (2021) 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int 100(4s):S1–s276 KDIGO (2021) 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int 100(4s):S1–s276
46.
Zurück zum Zitat KDIGO (2024) 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 105(4s):S117–s314 KDIGO (2024) 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int 105(4s):S117–s314
47.
Zurück zum Zitat Rauen T et al (2015) Intensive Supportive Care plus Immunosuppression in IgA Nephropathy. N Engl J Med 373(23):2225–2236PubMed Rauen T et al (2015) Intensive Supportive Care plus Immunosuppression in IgA Nephropathy. N Engl J Med 373(23):2225–2236PubMed
48.
Zurück zum Zitat Wang Q et al (2022) Impact of body mass index on primary immunoglobulin A nephropathy prognosis: a systematic review and meta-analysis. Int Urol Nephrol 54(5):1067–1078PubMed Wang Q et al (2022) Impact of body mass index on primary immunoglobulin A nephropathy prognosis: a systematic review and meta-analysis. Int Urol Nephrol 54(5):1067–1078PubMed
49.
Zurück zum Zitat Berthoux F, Mariat C, Maillard N (2013) Overweight/obesity revisited as a predictive risk factor in primary IgA nephropathy. Nephrol Dial Transplant 28(Suppl 4: p):iv160–6PubMed Berthoux F, Mariat C, Maillard N (2013) Overweight/obesity revisited as a predictive risk factor in primary IgA nephropathy. Nephrol Dial Transplant 28(Suppl 4: p):iv160–6PubMed
50.
Zurück zum Zitat Wang S et al (2021) Cigarette smoking may accelerate the progression of IgA nephropathy. BMC Nephrol 22(1):239PubMedPubMedCentral Wang S et al (2021) Cigarette smoking may accelerate the progression of IgA nephropathy. BMC Nephrol 22(1):239PubMedPubMedCentral
51.
Zurück zum Zitat Reich HN et al (2007) Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol 18(12):3177–3183PubMed Reich HN et al (2007) Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol 18(12):3177–3183PubMed
52.
Zurück zum Zitat Cheng J et al (2009) ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. Int J Clin Pract 63(6):880–888PubMed Cheng J et al (2009) ACEI/ARB therapy for IgA nephropathy: a meta analysis of randomised controlled trials. Int J Clin Pract 63(6):880–888PubMed
53.
Zurück zum Zitat Geng DF et al (2014) Antiproteinuric effect of angiotensin receptor blockers in normotensive patients with proteinuria: a meta-analysis of randomized controlled trials. J Renin Angiotensin Aldosterone Syst 15(1):44–51PubMed Geng DF et al (2014) Antiproteinuric effect of angiotensin receptor blockers in normotensive patients with proteinuria: a meta-analysis of randomized controlled trials. J Renin Angiotensin Aldosterone Syst 15(1):44–51PubMed
54.
Zurück zum Zitat - (2024) Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 12(1):39–50PubMed - (2024) Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 12(1):39–50PubMed
55.
Zurück zum Zitat Heerspink HJL et al (2020) Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 383(15):1436–1446PubMed Heerspink HJL et al (2020) Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 383(15):1436–1446PubMed
56.
Zurück zum Zitat - (2022) Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. Lancet 400(10365):1788–1801PubMedPubMedCentral - (2022) Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. Lancet 400(10365):1788–1801PubMedPubMedCentral
57.
Zurück zum Zitat Rovin BH et al (2023) Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2‑year results from a randomised, active-controlled, phase 3 trial. Lancet 402(10417):2077–2090PubMed Rovin BH et al (2023) Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2‑year results from a randomised, active-controlled, phase 3 trial. Lancet 402(10417):2077–2090PubMed
58.
Zurück zum Zitat Fellstrom BC et al (2017) Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial. Lancet 389(10084):2117–2127PubMed Fellstrom BC et al (2017) Targeted-release budesonide versus placebo in patients with IgA nephropathy (NEFIGAN): a double-blind, randomised, placebo-controlled phase 2b trial. Lancet 389(10084):2117–2127PubMed
59.
Zurück zum Zitat Wimbury D et al (2024) Targeted-release budesonide modifies key pathogenic biomarkers in immunoglobulin A nephropathy: insights from the NEFIGAN trial. Kidney Int 105(2):381–388PubMed Wimbury D et al (2024) Targeted-release budesonide modifies key pathogenic biomarkers in immunoglobulin A nephropathy: insights from the NEFIGAN trial. Kidney Int 105(2):381–388PubMed
60.
Zurück zum Zitat Rauen T et al (2020) After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy. Kidney Int Rauen T et al (2020) After ten years of follow-up, no difference between supportive care plus immunosuppression and supportive care alone in IgA nephropathy. Kidney Int
61.
Zurück zum Zitat Rivedal M et al (2024) Use of corticosteroids in Norwegian patients with immunoglobulin a nephropathy progressing to end-stage kidney disease: a retrospective cohort study. BMC Nephrol 25(1):42PubMedPubMedCentral Rivedal M et al (2024) Use of corticosteroids in Norwegian patients with immunoglobulin a nephropathy progressing to end-stage kidney disease: a retrospective cohort study. BMC Nephrol 25(1):42PubMedPubMedCentral
62.
Zurück zum Zitat Storrar J et al (2022) The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience. PLoS ONE 17(e0268421):9 Storrar J et al (2022) The epidemiology and evolution of IgA nephropathy over two decades: A single centre experience. PLoS ONE 17(e0268421):9
63.
Zurück zum Zitat Ștefan G et al (2022) Immunosuppressive therapy versus supportive care in IgA nephropathy patients with stage 3 and 4 chronic kidney disease. Medicine 101(e30422):36 Ștefan G et al (2022) Immunosuppressive therapy versus supportive care in IgA nephropathy patients with stage 3 and 4 chronic kidney disease. Medicine 101(e30422):36
64.
Zurück zum Zitat Lv J et al (2017) Effect of Oral Methylprednisolone on Clinical Outcomes in Patients With IgA Nephropathy: The TESTING Randomized Clinical Trial. JAMA 318(5):432–442PubMedPubMedCentral Lv J et al (2017) Effect of Oral Methylprednisolone on Clinical Outcomes in Patients With IgA Nephropathy: The TESTING Randomized Clinical Trial. JAMA 318(5):432–442PubMedPubMedCentral
65.
Zurück zum Zitat Kim D et al (2024) The Efficacy and Safety of Reduced-Dose Oral Methylprednisolone in High-Risk Immunoglobulin A Nephropathy. Kidney Int Rep 9(7):2168–2179PubMedPubMedCentral Kim D et al (2024) The Efficacy and Safety of Reduced-Dose Oral Methylprednisolone in High-Risk Immunoglobulin A Nephropathy. Kidney Int Rep 9(7):2168–2179PubMedPubMedCentral
66.
Zurück zum Zitat Lv J et al (2022) Effect of Oral Methylprednisolone on Decline in Kidney Function or Kidney Failure in Patients With IgA Nephropathy: The TESTING Randomized Clinical Trial. JAMA 327(19):1888–1898PubMedPubMedCentral Lv J et al (2022) Effect of Oral Methylprednisolone on Decline in Kidney Function or Kidney Failure in Patients With IgA Nephropathy: The TESTING Randomized Clinical Trial. JAMA 327(19):1888–1898PubMedPubMedCentral
67.
Zurück zum Zitat Medjeral-Thomas NR et al (2020) Randomized, Controlled Trial of Tacrolimus and Prednisolone Monotherapy for Adults with De Novo Minimal Change Disease: A Multicenter, Randomized, Controlled Trial. Clin J Am Soc Nephrol 15(2):209–218PubMedPubMedCentral Medjeral-Thomas NR et al (2020) Randomized, Controlled Trial of Tacrolimus and Prednisolone Monotherapy for Adults with De Novo Minimal Change Disease: A Multicenter, Randomized, Controlled Trial. Clin J Am Soc Nephrol 15(2):209–218PubMedPubMedCentral
68.
Zurück zum Zitat Barratt J et al (2024) Phase 2 Trial of Cemdisiran in Adult Patients with IgA Nephropathy: A Randomized Controlled Trial. Clin J Am Soc Nephrol 19(4):452–462PubMed Barratt J et al (2024) Phase 2 Trial of Cemdisiran in Adult Patients with IgA Nephropathy: A Randomized Controlled Trial. Clin J Am Soc Nephrol 19(4):452–462PubMed
Metadaten
Titel
IgA-Nephropathie
verfasst von
Dr. med. Claudia Seikrit
Jürgen Floege, Prof. Dr. med.
Publikationsdatum
28.11.2024
Verlag
Springer Medizin
Erschienen in
Die Nephrologie / Ausgabe 1/2025
Print ISSN: 2731-7463
Elektronische ISSN: 2731-7471
DOI
https://doi.org/10.1007/s11560-024-00811-5

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Neu im Fachgebiet Innere Medizin

Wenn die Asthma-Therapie an die Nebenniere geht

Auch unter einer Therapie mit inhalativen Kortikosteroiden kann es zu einer Nebenniereninsuffizienz kommen, wie eine kanadische Kasuistik veranschaulicht.

Junge Brustkrebspatientinnen zum Durchhalten motivieren

Patientinnen, die in jungen Jahren an Hormonrezeptor-positivem Brustkrebs erkranken, neigen dazu, die adjuvante endokrine Therapie auszusetzen oder abzubrechen. Die schlechte Therapiepersistenz scheint die Rückkehr des Tumors zu begünstigen.

Mehr Nierenkrebs bei regelmäßiger Einnahme von NSAR?

In der Allgemeinbevölkerung ist die wiederholte Verordnung von nichtsteroidalen Antirheumatika (NSAR) mit einem leicht erhöhten Nierenkrebsrisiko assoziiert. Dieses Ergebnis einer schwedischen Registerstudie ist allerdings mit einigen Fragezeichen zu versehen. 

Hochrisiko-Spinaliom am besten mit der Mohs-Chirurgie entfernen

Die Mohs-Chirurgie ist zwar mit mehr Aufwand verbunden als die herkömmliche Exzision; für die Versorgung kutaner Hochrisiko-Plattenepithelkarzinome lohnt sich die zeitintensive Technik aber in jedem Fall. Laut einer aktuellen Studie sinkt im Vergleich das Sterberisiko.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.