January 18, 2008

IGA-nephropathy

By Lisa Stein

Average Stage IgAN Diagnosis - It is common for IgAN to be discovered at a stage where the symptoms are further advanced than early stage IgAN. Prior to this time a slightly elevated urine protein level or the presence of slight hematuria may have been dismissed by many doctors as not worthy of further diagnosis as many transient conditions can present with those symptoms. However if proteinuria is distinctly elevated in the range of 750-1250mg/24hr. or shows as a +3 or +4 on a urine dipstick test a doctor may be expected to look carefully into the cause. If significant hematuria is also present a doctor familiar with IgAN will be drawn towards that diagnosis. Microscopic findings of "red blood cell casts" in a urine sample along with proteinuria and hematuria are certainly indicative of some form of glomerulenephritis, most likely IgAN. Frequently the patients blood pressure is somewhat elevated at this stage but may be considered borderline high blood pressure. A medically correct diagnosis of IgAN however cannot be made without a renal or kidney biopsy and this is a common diagnostic procedure at this stage of IgAN."

Following is regimen for IgA nephropathy

Vitamin E

The evidence for Vitamin E supplements as a standard treatment for a variety of kidney diseases especially the glomerulnephritis' is overwhelming. This common nutriceutical (nutritional supplement) protects sensitive kidney membranes by acting as an anti-oxidant with especially effective activity on membranes and with various lipids (fats.) A daily Vitamin E capsule of 500IU provides considerable help for IgAN according to many published papers.

Fish Oil with high concentration of Omega 3 Fatty Acids.

Fish oil capsules which contain two omega 3 fatty acids EPA and DHA have been reported in the medical literature as being effective in treating a wide range of circulatory and immune disorders including specifically IgA Nephropathy. The dose required is very high amounting to 12 - 1 gram capsules per day of fish oil containing an EPA level of 180mg/capsule and a DHA level of 120mg/capsule. One of the key mechanisms is believed to act on the fragile blood filtering membranes in the kidney. In IgAN immune system the IgA immune system antibody is found to interfere with the function of these glomeruli membranes.

ACE inhibitors and other Blood Pressure Medications

ACE inhibitors, specifically those with names like enalapril (Vasotec), lisinopril (Zestril), etc. have been shown in studies to be effective in reducing protein losses in the urine from patients with various forms of kidney disease including IgAN. Other studies have shown that some of the Beta Blocker blood pressure medications have a similar effect. The kidney in fact is a primary regulator of blood pressure via a complex mechanism. Essentially the kidney can turn up the blood flow via a rise in blood pressure in response to diminished kidney function (kidney disease). Higher than normal blood pressure is always harmful to the fragile filtering membranes of the kidney. A irksome design flaw in our otherwise wonderfully evolved kidneys.

It is logical to conclude, as many scientists have in published papers, that controlling blood pressure will preserve the filtering membranes of the kidney. Such is indeed the case as is evidenced by both the immediate and long term effects of the use of blood pressure medications for kidney disease. There are a side effects of various blood pressure medications and prescription of such medication needs to weigh the pros and cons carefully.

There are however a number of things one can do to keep your blood pressure at a low level. Buying a blood pressure measuring device and taking your blood pressure frequently and keeping a record can tell you a lot about what foods and habits do to your blood pressure. Exercise and fitness is a first line defense. A low salt diet, if you are salt intolerant, can be quite effective. Common diuretic foods like tea, grapefruit juice, etc. can help if you show signs of edema (swelling of the feet, lower legs, or puffy eyes.)

Steroid Treatment - Prednisone

Treatment of IgAN with high dose daily or alternate day steroids, principally prednisone is often prescribed especially in rapidly progressing cases. This treatment is a very powerful one which surpresses the entire immune system of the individual and has serious side effects. It has however been shown to be effective in arresting rapid decline to otherwise imminent kidney failure in several kidney diseases including IgAN. It is imperfectly effective in that not all patients kidney disease respond to the treatment.

Tonsillectomy

Since IgAN is an auto immune disorder and immune complex disease considerable attention has been given to the apparent immune system characteristics of the disease. It is perfectly established that the disease is characterized by the presence of the IgA antibody protein as deposits in the glomeruli of the kidney. Many studies have shown that the IgA found in IgAN deposits is a particular IgA form that is primarily produced by the immune tissue components found primarily though not exclusively in the mouth, throat, and nasal regions. The largest immune components in the oral cavity are the tonsils and hence it has been shown that something like 90% of the particular IgA proteins circulating in our bodies that is responsible for IgAN comes from the tonsils. When this connection was revealed in the scientific literature 20 years ago many doctors around the world came to the obvious conclusion that a possible treatment was to remove the tonsils.

As it happens tonsillectomy is one of the most common surgeries performed in the world not as a treatment for IgAN but for a variety of other mostly infectious diseases and more recently as a treatment to alleviate snoring. Tonsillectomy however is also a much maligned treatment that was at one time over prescribed for adolescents in the modern western world. The result of that era of adolescent tonsillectomy ending in the early 1960's has been a backlash by many over the use of tonsillectomy for any purpose. Many doctors are thus very hesitant to discuss tonsillectomy for any but the most extreme frequently recurrent cases of severe streptococcal infections.

In the case of IgAN tonsillectomy is well reported upon in the scientific literature, though in small to medium sized studies, as being effective in the treatment of IgAN in approximately 60% of those patients undergoing it. The effect is not a cure of IgAN but rather a diminishment of the status and continuous decline shown by some of the most prominent symptoms including proteinuria, hematuria, and high cholesterol. Unfortunately this treatment has been mostly prescribed for patients in the late and most severe stages of IgAN where a large amount of kidney damage has already resulted from the progressing disease process.

All the patients need to have clean teeth use Hydrogen peroxide 3percent to wash and clean teeth twice a day.

All the patients need to stop using grain and use potatoes and vegetables.

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IGA-nephropathy