Immunoglobulin-A nephropathy is the most common chronic glomerulonephritis worldwide. Metabolic risk factors, such as hyperuricaemia and hypertriglyceridaemia, are associated with the progression of this condition.
Prognosis
Although considered as a benign glomerulopathy, IgA nephropathy is now a
well-known cause of end-stage renal disease (ESRD). Fifty percent of people
suffering from gA nephropathy develop renal insufficiency and 20 to 30% may reach ESRD
after 20 to 25 years of evolution.
Main Symptoms
Main symptoms are painless macrohematuria or microhematuria.
Natural Treatment of IgA Nephropathy
Treatment of IgA nephropathy with natural supplements has hardly been studied. I
have listed a few supplements and herbs that have been looked at, but before
starting a natural treatment program with these supplements,
make sure you discuss with your doctor.
Fish oils are
found in cold water fish and as supplements. It is certainly worthwhile to
consider adding omega-3 fish oils to one's supplement regimen.
Antioxidants such as Vitamins C, E, and
alpha lipoic acid
antioxidant
Cordyceps mushroom
White peony root
herb
Perilla frutescens herb
One option is to try each supplement for a period of 2 months, have a 2 week interval in between each one, and to see which one of these natural IgA nephropathy treatment options works best.
Fish oils, omega-3 fatty acids
The effect of EPA in patients with IgA nephropathy is not pronounced, but these
results suggest that EPA is a safe and worthwhile supplement to the drugs used
to treat this disease. Ther Apher Dial. 2010. Effects of eicosapentaenoic acid supplementation on immunoglobulin A nephropathy.
Treatment of severe IgA nephropathy with omega-3 fatty acids: the
effect of a "very low dose" regimen.
Ren Fail. 2004.
The effect of a "very low dose" of purified omega-3 fatty
acids (PFA) in the progression of severe IgA nephropathy was
tested, in a randomized, prospective, controlled trial. Fourteen
patients were assigned to receive a "very low dose" of PFA (0.85 g EPA and
0.57 g PHA) and 14 patients were treated symptomatically and used as
controls. Both groups were similar in terms of serum
creatinine (Scr) and
glomerular filtration rate (GFR) at baseline. Patients were treated for 4
years. A
"very low dose" of PFA is also effective in slowing renal progression in
high-risk patients with IgA Nephropathy and particularly those with advanced renal
disease.
Effect of 12-month therapy with omega-3 polyunsaturated acids on
glomerular filtration response to dopamine in IgA nephropathy.
Am J Nephrol. 2004.
Omega-3 polyunsaturated acids therapy is efficient in
primary IgA nephropathy. It is unknown whether doses of omega-3 smaller
than those given previously are still effective. The aim of the study was
to examine the effect of omega-3 therapy on renal vascular function in
relation to proteinuria and urinary excretion of N-acetyl-beta-D-glucosaminidase
(NAG). 20 IgA Nephropathy patients aged 36.5 +/- 10 with creatinine
clearance (Cr(cl)) 105 +/- 27 ml/min and proteinuria 3 +/- 2
g/24 h were given orally 810 mg EPA and 540 mg DHA daily for 12 months. Omega-3 supplementation is associated with the improvement of
both renal vascular function and tubule function in IgA Nephropathy
patients.
Oxidized omega-3 fatty acids inhibit pro-inflammatory responses in
glomerular endothelial cells.
Nephron Exp Nephrol. 2004.
Department of Pathology, University of Iowa of Iowa Hospitals and Clinics,
Iowa City, Iowa
Omega-3 fatty acids have beneficial effects in chronic
inflammatory diseases that are characterized by accumulation of leukocytes
and leukocyte-mediated tissue injury. Accumulation of leukocytes occurs,
in part, due to pro-inflammatory responses in endothelial cells, such as
increase in expression of leukocyte adhesion receptors and chemokines,
such as MCP-1 and IL-8. These studies show that the beneficial effects of fish oil in
chronic inflammatory diseases, including IgA nephropathy, may result from
the inhibitory effects of oxidized omega-3 fatty acids on pro-inflammatory
events in endothelial cells via inhibition of NF-kappaB activation.
Docosahexaenoic acid attenuates mycotoxin-induced immunoglobulin a
nephropathy, interleukin-6 transcription, and mitogen-activated protein
kinase phosphorylation in mice.
J Nutr. 2004. Jia Q, Zhou HR, Bennink M, Pestka JJ.
Department of Food Science and Human Nutrition, Michigan State University,
East Lansing, MI
The purpose of this investigation was to evaluate the dose-dependent
effects of docosahexaenoic acid (DHA) on deoxynivalenol (DON)-induced IgA
nephropathy in mice and their relation to proinflammatory gene expression
and mitogen-activated protein kinase (MAPK) activation. Taken together, the results
indicate that DHA dose-dependently inhibited DON-induced IgA dysregulation
and nephropathy, and that impairment of MAPK activation and expression of
COX-2 and IL-6 are potential critical upstream mechanisms.
Docosahexaenoic acid and eicosapentaenoic acid, but not alpha-linolenic
acid, suppress deoxynivalenol-induced experimental IgA nephropathy in
mice.
J Nutr. 2004.
Department of Food Science and Human Nutrition, and Center for Integrative
Toxicology, Michigan State University, East Lansing, MI
Diets enriched in the (n-3) PUFAs, docosahexaenoic acid (DHA),
eicosapentaenoic acid (EPA), and their precursor alpha-linolenic acid
(ALA), were evaluated for efficacy in ameliorating the development of IgA
nephropathy induced in mice by the mycotoxin deoxynivalenol (DON). Taken together, both DHA and EPA, but not ALA,
ameliorated the early stages of IgA Nephropathy, and these effects might be related
to a reduced capacity for IL-6 production.
The role of fish oil/omega-3 fatty acids in the treatment of IgA
nephropathy.
Semin Nephrol. 2004.
Division of Nephrology, the Department of Medicine, and the Department of
Laboratory Medicine and Pathology, Mayo Clinic & Mayo Foundation,
Rochester, MN
Fish and
marine oils are the most abundant and convenient sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the two major
n-3 fatty acids that serve as substrates for cyclooxygenase and
lipoxygenase pathways leading to less potent inflammatory mediators than
those produced through the n-6 PUFA substrate, arachidonic acid. N-3 PUFA
can also suppress inflammatory and/or immunologic responses through
eicosanoid-independent mechanisms. Although the pathophysiology of IgA
nephropathy is incompletely understood, it is likely that n-3 PUFA
prevents renal disease progression by interfering with a number of
effector pathways triggered by mesangial immune-complex deposition. In
addition, potential targets of n-3 PUFA relevant to renal disease
progression could be similar to those involved in preventing the
development and progression of cardiovascular disease by lowering blood
pressure, reducing serum lipid levels, decreasing vascular resistance, or
preventing thrombosis. In IgA nephropathy, efficacy of n-3 PUFA contained
in fish oil supplements has been tested with varying results. The largest
randomized clinical trial performed by our collaborative group provided
strong evidence that treatment for 2 years with a daily dose of 1.8 g of
EPA and 1.2 g of DHA slowed the progression of renal disease in high-risk IgA Nephropathy
patients. These benefits persisted after 6 years of follow up.
The long-term outcome of patients with IgA nephropathy treated with
fish oil in a controlled trial. Mayo Nephrology Collaborative Group.
J Am Soc Nephrol. 1999.
Department of Internal Medicine, Mayo Clinic & Foundation, Rochester,
Minnesota
It was reported previously that dietary fish oil supplementation retarded
the progression of renal disease in patients with IgA nephropathy in a
multicenter, placebo-controlled, randomized, 2-yr clinical trial. The aim
of this study was to determine the long-term influence of fish oil
treatment on renal progression in observations on the study cohort of 106
patients extending beyond the 2-yr trial. After a mean follow-up of 6.4 yr, 46
patients-17 in the fish oil group versus 29 in the placebo group-reached
the primary end point, and 27 patients-eight in the fish oil
group versus 19 in the placebo group-developed ESRD. At the
end of the 2-yr trial, 75 patients (45 fish oil, 30 placebo) remained at
risk for the primary end point. This is also when the double-blind part of
the trial ended, allowing physicians to stop supplements, switch original
placebo-assigned patients to fish oil, and continue fish oil in original
fish oil-assigned patients. A significantly greater number of nonsupplemented placebo patients developed the primary end point and ESRD
compared with long-term supplemented fish oil patients. By intention, BP
control, primarily treated with angiotensin-converting enzyme inhibition,
was equal in the fish oil and placebo groups. Proteinuria was modestly
reduced in both groups. It is concluded that early and prolonged treatment
with fish oil slows renal progression for high-risk patients with IgA
nephropathy.
IGA Nephropathy Treatment
research
Oxidative stress and damage induced by abnormal free radical reactions
and IgA nephropathy.
J Zhejiang Univ Sci B. 2005.
Division of Nephrology, School of Medicine, Zhejiang
University, Hangzhou China.
To estimate the oxidative stress and oxidative damage induced by
abnormal free radical reactions in IgA nephropathy patients' bodies.
Seventy-two IgA nephropathy patients and 72 healthy adult volunteers (HAV)
were enrolled in a random control study design, in which the levels of nitric
oxide (NO) in plasma, lipoperoxide (LPO) in plasma and in erythrocytes, and
vitamin C (VC), vitamin E (VE) and beta-carotene (beta-CAR) in plasma as well as
the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione
peroxidase (GPX) in erythrocytes were determined with spectrophotometric
methods. Compared with the HAV group, the averages of NO in plasma, and
LPO in plasma and in erythrocytes in the IgA nephropathy group were
significantly increased, while those of VC, VE and beta-CAR in plasma
as well as those of SOD, CAT and GPX in erythrocytes in the IgA nephropathy
group were significantly decreased. Linear correlation analysis
showed that with the increase of the values of NO, and LPO in plasma and in
erythrocytes, and with the decrease of those of VC, VE, beta-CAR, SOD, CAT and
GPX in the IgAN patients, the degree of histological damage of
tubulointerstitial regions was increased gradually; and that with the
prolongation of the duration of disease the values of NO, and LPO in plasma and
erythrocytes were increased gradually, while those of VC, VE, beta-CAR, SOD, CAT
and GPX were decreased gradually. The discriminatory correct rates of
the above biochemical parameters reflecting oxidative damage of the IgA
nephropathy patients were 73%-92%, and the correct rates for the HAV were
70%-91% when independent discriminant analysis was used; and the correct
rate for the IgA nephropathy patients was increased to 98%, the correct rate
for the HAV was increased to 100% when stepwise discriminant analysis was used. A series of
free radical chain reactions caused serious pathological aggravation in the IgA
nephropathy patients' bodies, thus resulting in oxidative damage in their
bodies. In treating IgA nephropathy, therefore, it is necessary that suitable
dose antioxidants should be supplemented to them so as to alleviate the
oxidative damage in their bodies.
Pathogenesis of IgA nephropathy.
Semin Nephrol. 2004.
In IgA nephropathy, there is dysregulation of the IgA response
to a wide range of antigens. The dysregulation promotes synthesis of
polymeric IgA1 (pIgA1) with physicochemical characteristics that favor
mesangial deposition, including altered O-glycosylation of the hinge
region. This may be the synthesis of IgA in the systemic compartment,
which has the phenotype of mucosal IgA. There is not a change in IgA1
structure to an entirely abnormal form; rather, there is a shift that
results in a proportional increase in forms of IgA1 also found in healthy
individuals. Altered O-glycosylation could favor pIgA1 deposition by
promoting formation of macromolecular IgA and immune complexes. Mesangial
injury follows through interactions of pIgA1 with the cells and
extracellular matrix proteins of the mesangium and the activation of
complement. The final clinical expression of IgA Nephropathy also depends on generic
factors, including hypertension and proteinuria, and a fibrotic renal
response. No single IgA Nephropathy gene has been identified, and it is likely that
multiple interacting genes will eventually prove to underlie
susceptibility to IgA Nephropathy and the risk of progressive renal
disease.
Clinical study on dan shao tang in treating IgA
nephropathy of deficiency of yin with damp-heat symptom
Zhong Yao Cai. 2003.
To explore the effect of Dan Shao Tang in treating IgA
nephropathy of deficiency of Yin with damp-heat symptom. METHODS: 90
patients with IgA nephropathy of deficiency of Yin with damp-heat symptom
were randomly divided into two groups. 50 patients in treatment group were
treated with Dan Shao Tang and western medicine and 40 patients in control
group were treated only with western medicine. The effects and changes of
the indexes including renal function, hematuria, proteinuria, blood IgA
before and after treatment were observed. After six months
treatment, the general effective rate in treatment group was 70%, which
was markedly higher than that in control group.
Treatment group is obviously better than control group on decreasing hematuria, proteinuria, blood IgA and improving renal function.
Dan Shao Tang is effective on IgA nephropathy of deficiency of
Yin with damp-heat symptom.
The effect of the extract from Radix Paeoniae alba on IgA
Glomerulonephritis in mice
Zhong Yao Cai. 2003.
To observe the effect of the extract from Radix Paeoniae Alba (
white peony root )on IgA glomerulonephritis in mice. METHODS: IgA
glomerulonephritis was induced by injection of dextran and sephadex-150.
After administrating the extract, the contents of urinary protein, BUN and
Cr in serum were determined. RESULTS: The extract could inhibit the
decline of mouse weight, and decrease urinary protein content and BUN
content in serum. While, the extract had no effect on Cr in serum.
The extract from Radix Paeoniae Alba had therapeutical effect
on IgA glomerulonephritis.
Suppressive effects of Perilla frutescens on IgA nephropathy in HIGA
mice.
Nephrol Dial Transplant. 2003.
Perilla frutescens (perilla) is a herbal medicine used in
Japanese traditional Kampo medicine. The present study was conducted to
evaluate the anti-nephritic effects of perilla in HIGA mice that
spontaneously develop high levels of serum immunoglobulin A (IgA) along
with mesangial IgA deposition. A perilla decoction and its major
active constituent, rosmarinic acid (RsA), were orally administrated to
10-week-old HIGA mice for 16 weeks. Perilla suppressed proteinuria, proliferation
of glomerular cells, serum levels of IgA, glomerular IgA and IgG
depositions in HIGA mice. Cultured Peyer's patch cells and spleen cells
from perilla-treated mice produced significantly less IgA than controls.
Rosmarinic acid, by itself, suppressed serum IgA levels and glomerular IgA
deposition in HIGA mice. Cultured spleen cells from RsA-treated mice
produced less IgA than controls. The perilla decoction may
suppress IgA nephropathy, in part, through modulation of the intestinal
mucosal immune system. These effects were caused by rosaminic acid acting
synergistically with other constituents.
Clinical study on Shenning Mixture in treating IgA
nephropathy
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000.
To study the clinical therapeutic effect of Shenning Mixture
(SNM) in treating IgA nephropathy. Patients were treated
separately with SNM or prednisone by randomized grouping. The criteria,
including clinical symptoms, signs, hematuria, albuminuria and immune
globulin were observed. The total effective rate and the complete
remission rate in the SNM group were 97% and 45% respectively, while
in the control group, they were 37% and 8% respectively. Comparison of
the two groups showed that the therapeutic effect in the former was better
than that in the latter significantly. The hematuria and
albuminuria extenuated and serum IgA lowered more significantly in the SNM
group than those in the control group. SNM has obvious therapeutic effect on the hematuria and albuminuria in
treating IgA nephropathy.
Inhibition of activated human mesangial cell proliferation by the
natural product of Cordyceps sinensis (H1-A): an implication for treatment
of IgA mesangial nephropathy.
J Lab Clin Med. 1999.
Cordyceps sinensis is a parasitic fungus that has been used as a
Chinese medicine for a long time in the treatment of nephritis. Today, the
hypothesis about the pathogenesis of immunoglobulin A nephropathy
is that nephritogenic IgA immune complexes (IgAIC) go to the kidney to
stimulate resting mesangial cells to release cytokines and growth factors.
These cytokines and growth factors cause mesangial cell proliferation and
release matrix, chemical mediators that lead to the glomerular injury.
However, nephritogenic IgAIC in humans is still unknown. To solve this
problem previously, we established an in vitro model that showed that
cultured human mesangial cells (HMC) stimulated with interleukin-1 (IL-1)
plus IL-6 can cause mesangial cell proliferation, increasing production of
chemical mediators and superoxide anion. An in vivo model also proved that
this culture medium may lead to renal injury with hematuria and
proteinuria. These results give us a new regimen for the
treatment of patients with IgA Nephropathy in the future. iga nephropathy bergers disease
cause of iga nephropathy.
Managing
Henoch-Schonlein purpura in children with fish oil and ACE inhibitor
therapy.
Nephrology (Carlton). 2004.
Department of Pediatrics, Steele Memorial Children's Research, University
of Arizona, Tucson, Arizona
The kidney biopsy in Henoch-Schonlein purpura shows IgA deposits
and fish-oil therapy has proven to be promising in halting the progression of
IgA nephropathy. Five children with biopsy-proven HSP with repeated
episodes of haematuria and proteinuria were treated with fish oil (1 g orally
twice daily). In three of the five patients an angiotensin-converting enzyme
inhibitor (ACEI) was added for hypertension. This is the first report of abatement
of Henoch-Schonlein purpura with fish oil and ACEI in children. There is a need for randomized
prospective trials to confirm this observation.
Emails
Have you seen any research with
idebenone and this
kidney disorder?
I have not.