Importance of blood pressure control in the management of nephrotic proteinuria in patients with IgA nephropathy

Authors

  • Thales de Angelis Ciminelli Hospital de Base/Médico residente https://orcid.org/0009-0007-2691-2074
  • Allana Karine Lima Ribeiro
  • Tania Maria de Souza Fontes
  • Joanny Araújo da Silva Monteiro

DOI:

https://doi.org/10.51723/hrj.v6i32.1218

Keywords:

Glomerulonefrite por IgA; Síndrome nefrótica; Hipertensão.

Abstract

Objective: this article aims to review the effect of proteinuria on a patient diagnosed with IgA nephropathy (IgAN), with a clinical presentation of altered renal function and nephrotic-range proteinuria. The patient was undergoing treatment with immunosuppressants, antiproteinuric medications, and blood
pressure control at a tertiary hospital in the Federal District – Hospital de Base do Distrito Federal (HBDF). It also conducts a brief literature review on the subject. Methods: the methodology for creating this review article was based on two main axes: a literature review and data collection from a clinical
experience of a patient with IgA nephropathy. Results: based on the analysis of the pathophysiology, pathophysiology, and clinical evolution with therapeutic optimization, it was observed that immunosuppression was no longer necessary after clinical optimization. Conclusion: it is concluded that, before administering
immunosuppressive treatment to a patient with IgA nephropathy, clinical optimization of the treatment is necessary, given the possible adverse and side effects of more intense immunosuppression.

References

1. Barbour SJ, Espino-Hernandez G, Reich HN, Coppo R, Roberts ISD, Feehally J et al. The MEST score provides earlier risk prediction in IgA nephropathy. Kidney Int. 2016;89(1):167-75. doi: 10.1016/j. kint.2015.09.018.

2. Campos MF et al. Fisiopatologia e clínica da Nefropatia por IgA: uma revisão de literatura. Res Soc Dev. 2024;13(7):e9113746378. doi:10.33448/rsd-v13i7.46378.

3. Costa VBA, Assunção LIS, Silveira TÁ, Silveira NÁ. Nefropatia por imunoglobulina A: uma revisão abrangente. Braz J Health Rev. 2024;7(5):e73463. doi:10.34119/bjhrv7n5-386.

4. Crowley-Nowick PA, Julian BA, Wyatt RJ et al. IgA nephropathy in blacks: studies of IgA2 allotypes and clinical course. Kidney Int. 1991;39:1218.

5. Donadio JV, Grande JP. IgA nephropathy. N Engl J Med. 2002;347:738.

6. Floege J, Bernier-Jean A, Barratt J, Rovin B. Treatment of patients with IgA nephropathy: a call for a new paradigm. Kidney Int. 2025;107:640.

7. Galla JH. IgA nephropathy. Kidney Int. 1995;47:377.

8. Li LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. Kidney Int. 2004 Sep;66(3):920-3. doi: 10.1111/j.1523-1755.2004.00837.x.

9. Li LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. Kidney Int. 2004;66:920-3.

10. Miyabe Y et al. Grading system utilising the total score of Oxford classification for predicting renal prognosis in IgA nephropathy. Sci Rep. 2021;11:3584. doi: 10.1038/s41598-021-82967-x.

11. O’Shaughnessy MM, Hogan SL, Thompson BD, Coppo R, Fogo AB, Jennette JC et al. Glomerular disease frequencies by race, sex and region: results from the International Kidney Biopsy Survey. Nephrol Dial Transplant. 2018 Apr;33(4):661-9. doi:10.1093/ndt/gfx189.

12. Ribeiro LC, Woronik V. Tratamento da Nefropatia por IgA. J Bras Nefrol. 2005;27(2 Suppl 1):18-21. Disponível em:

https://bjnephrology.org/wp-content/uploads/2019/11/jbn_v27n2s1a08.pdf

13. Soares MF. Atualização em nefropatia da IgA. J Bras Nefrol. 2016;38(4):435-440. doi:10.5935/0101- 2800.20160069.

14. Trimarchi H, Barratt J, Cattran DC et al. IgAN Classification Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Conference Participants. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017;91(5):1014–21. doi: 10.1016/j.kint.2017.02.003.

15. Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013 Jun 20;368(25):2402-14. doi:10.1056/ NEJMra1206793.

16. Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013;368:2402.

17. Yeo SC, Goh SM, Barratt J. Is immunoglobulin A nephropathy different in different ethnic populations? Nephrology (Carlton). 2019 Sep;24(9):885-895. doi:10.1111/nep.13592. PMID: 30977248.

18. Yeter HH et al. Combining clinical features and MEST-C score in IgA nephropathy may be a better determinant of kidney survival. Rom J Intern Med. 2020;58(4):209-218. doi:10.2478/rjim-2020-0025.

Additional Files

Published

2025-09-10

How to Cite

de Angelis Ciminelli, T., Karine Lima Ribeiro, A., Maria de Souza Fontes, T., & Araújo da Silva Monteiro, J. (2025). Importance of blood pressure control in the management of nephrotic proteinuria in patients with IgA nephropathy. Health Residencies Journal - HRJ, 6(32). https://doi.org/10.51723/hrj.v6i32.1218

Issue

Vol. 6 No. 32 (2025): Formação em Saúde e Práticas Integradas: Desafios e Evidências na Atenção Contemporânea

Section

Relato de caso

License

Copyright (c) 2025 Thales de Angelis Ciminelli, Allana Karine Lima Ribeiro, Tania Maria de Souza Fontes, Joanny Araújo da Silva Monteiro

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Esta licença permite que outros distribuam, remixem, adaptem e desenvolvam seu trabalho, mesmo comercialmente, desde que atribuam crédito à revista pela criação original.