IgA Nephropathy Uncovered: Symptoms, Diagnosis & Latest Treatments
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- Опубліковано 19 лип 2024
- Are you interested in a life that's not just longer but also healthier? Dr. Sean Hashmi delves into kidney health, nutrition, weight loss, and the science of longevity in our weekly "Live Long & Thrive" webinar. Each episode is packed with actionable, evidence-based advice, so mark your calendar, prepare your questions, and subscribe today!
Timestamps
00:00 Start
1:26 What is IgA nephropathy
7:56 Other diseases linked to IgA
8:40 Prevention of IgA nephropathy
10:02 Symptoms
15:11 Diagnosis
17:57 Treatment
References:
-World Health Organization . Guideline: Sodium Intake for Adults and Children. World Health Organization; Geneva, Switzerland: 2012. pp. 1-46.
-Wright JA, Cavanaugh KL. Dietary sodium in chronic kidney disease: a comprehensive approach. Semin Dial. 2010 Jul-Aug;23(4):415-21.
-Verma A, Popa C. The Interplay Between Dietary Sodium Intake and Proteinuria in CKD. Kidney Int Rep (2023) 8, 1133-1136
-Reich, H et al. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177.
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Thanks for joining the livestream. If you missed it, we have these live streams weekly on Fridays from 5pm-530pm PST. This video covers everything you need to know about IgA nephropathy from diagnosis to treatment. See you next week!. 2 meds that I didn't have time to cover. First was target-release budesonide (Tarpeyo). This is an oral targeted release formulation of budesonide that releases in the distal ileum of the small interesting where its thought that IgA1 production is occurring. It has 90% first-pass liver clearance so has much less systemic sffect than oral steroids. This is the key selling point for tarpeyo. The second drug is sibeprenlimab. A Proliferation-Inducing Ligand (APRIL) is shown in the pathogensis of IgA nephropathy. When we look at patients with IgA, we see that APRIL levels are higher in their blood. A phase II study showed that sibeprenlimab had up to a 62% reduction in 24 hour proteinuria at 12 months (vs 20% with placebo). The best part was the adverse events were similar between the two groups.
References:
-World Health Organization . Guideline: Sodium Intake for Adults and Children. World Health Organization; Geneva, Switzerland: 2012. pp. 1-46.
-Wright JA, Cavanaugh KL. Dietary sodium in chronic kidney disease: a comprehensive approach. Semin Dial. 2010 Jul-Aug;23(4):415-21.
-Verma A, Popa C. The Interplay Between Dietary Sodium Intake and Proteinuria in CKD. Kidney Int Rep (2023) 8, 1133-1136
-Reich, H et al. Remission of proteinuria improves prognosis in IgA nephropathy. J Am Soc Nephrol. 2007;18(12):3177
Thank you for this presentation on IGA nephropathy! I love how you explain things. You seem so genuine and keen to help and educate ❤
Listening Tonight from San Diego County. ☔ We Love & Appreciate You, Dr. Hashmi. ❤️ Thank You, So Much for Everything That You Do.
Thank you so much! I went to med school back in the day at UCSD :)
Listening from mauritius very clear and concise explanation.Thank you Doctor.
So glad I found you. I am 88 and have been on a Plant Based, calorie restriction diet for 3 years now. I have good health and a good mind, do my own shopping, cooking and have a great scooter to get around. My knees are my biggest problem and an irregular heart beat. I have a good Doctor and have heart beat under control. I have been listening to many of your tube videos on your advice and information. Thanks, Blessings to you, your daughters and wife.
I was diagnosed through a kidney biopsy to have MCD. I had never been sick before, I am slim and eat mostly vegetarian but not all. No idea why this happenbed. Was put on a course of Prednisone, starting with 60 mg. The kidneys are still, thank goodness, in the normal range. I noticed before that I have less foaming in the urine when I eat plant-based protein. I told this to my nephrologist but he was not impressed. I now take Ramipril for blood pressure and Jardiance. The blood pressure has gone down considerably but want it to reduce even more. I saw, accidentally, your video on plant-based diet which made logical sense to me. I now fill an egg cup with 4 g salt and I salt no food. I add it from my reserve of 4 grams. I have salt in my home-baked bread. Am keeping a diary and it is too early to tell, but the foaming reduced drastically with almost no salt and plant based protein even after 1 day! I also took Atorvastatin but I discontinued this to find out, if it causes the extreme hair loss. The problem is that many conventional doctors only treat with tablets and one needs to make ones own research, and not fall for sensationalism. I am from Northern Germany and am 80.
Thanks. I am listening from Australia.i have been a long time listener.
You are a breath of fresh air. Thank you.
Thank you Dr. for this great speech.
Thank you for the information
Great presentation !!
Listening from SE Asia and a regular listener.
Thanks
Excellent info. Best nephro on youtube. Are there any good books on this subject that you recommend?
My neph. Has me on 100 mg of Losartan and 20 mg of Lisinopril. He was very hesitant to give the okay on Jardiance after his fill in Dr. Prescribed Farxiga, but insurance doesn't cover that anymore. His interim Dr. did not want me to take both ARB and Ace inhibitors. I have cut my losartan in half on my own, and my GFR has improved. My creatinine levels are slowly improving. What are your thoughts
Hi Sean, thanks for the video. Could you make a particular video covering Tarpeyo? It would be great with a video solely covering it's use given it's the first FDA approved medicine that has a proven disease modifying effect on IgA Nephropathy. Thanks again
Wonderful informative video Sean, can you discuss Tarpeyo (Budesonide) and other new drugs as well as those mentioned here.
Thank you❤👏
Let me put the comment on the top since I ran out of time on tarpeyo and sibeprenlimab. See the pinned comment above.
I'll copy the comment here: "2 meds that I didn't have time to cover. First was target-release budesonide (Tarpeyo). This is an oral targeted release formulation of budesonide that releases in the distal ileum of the small interesting where its thought that IgA1 production is occurring. It has 90% first-pass liver clearance so has much less systemic sffect than oral steroids. This is the key selling point for tarpeyo. The second drug is sibeprenlimab. A Proliferation-Inducing Ligand (APRIL) is shown in the pathogensis of IgA nephropathy. When we look at patients with IgA, we see that APRIL levels are higher in their blood. A phase II study showed that sibeprenlimab had up to a 62% reduction in 24 hour proteinuria at 12 months (vs 20% with placebo). The best part was the adverse events were similar between the two groups."
@@SELFPrinciple thank you👏❤️
My friend has IgG4 kidney disease. What's the difference between IgA and IgG4?
Doc I have been diagnosed with seronegative celiac disease 7 years ago.
I also had gastroparesis, EoE and colitis.
Now after 7 years I have high hemoglobulin and on my urine test I have a really high lymphocytes count.
Are there any correlation between immature cd19 and kidney failure ?
Thanks
Hello, thx for the video!
Am I understood correctly if f.e. I got less protein than 0.5 g per day only on losartan does that mean that I don't have to add more medications and stay on losartan further?
Had kidney transplant due to IGA. Appreciate IGA program as rarely hear information. Having increased protein and creatinine after recent flu so concerned about recurrence of IGA in transplanted kidney. I will ask more questions on what I heard as treatments may have changed since I first had it. Also not sure how much if audience has had transplants but a program about lab values etc with one kidney and specifics issues with immunosuppresion would be a suggestion.
Hey how are you what you find out do they do biopsy
If proteinuria goes over 1000 mgdl and it is progressive then it may lead to ESRD
Stage 3a, bp 117/62 on avg, Creatinine 1.11,UA Macroscopic comes back neg for protein everytime! taking 2 meds, hydrochlorothiazide 25mg & Lisinopril 2.5mg, have cysts on both kidneys, liver & now pancreas, no swelling & very little itching, no special diet.
Its a good idea to talk to a renal dietitian and explore how a plant predominant diet has been shown to be beneficial in kidney disease. There are lots of videos on this channel as a starting point to learn.
Cut the sugar, your body actually doesn't need dietary sugar at all, glucose included. That will really help with your cysts, people here have cleared their PCOS by eliminating dietary sugar.
@@Caladcholg I do not eat sweets, no soda, candy etc. my deit is vegetarian mostly very little fruits.
@@SoftailBaby awesome, avoiding the processed foods and added sugars are the most universally beneficial thing anyone can do (or rather, stop doing 😁) for their health! Keep it up.
@@Caladcholg There was a study I presented where the authors showed that cysts wall relied on sugar to grow. So this is a great point.
I'm spilling about 300mg/day protein and it has been stable since i was diagnosed by biopsy 3 years ago. My doc has put me on candarsartan 4mg. My natural blood pressure is around 120/80 and not much lower on candarsartan. There doesn't seem to be any difference in my proteinuria with or without condarsartan. Is it still adviced for me to continue the medication?
❤❤❤❤
I was diagnosed with Bell's Palsy and Ear infection at the end of the year. How will this affect my Kidneys. I'm also Bipolar.
Any suggestions
Hi there. I am so sorry to hear about your Bell's palsy. wishing you a speedy recovery. I am not aware of a direct impact on kidneys from bells palsy
One more question:) i was initially diagnosed with vasculitis IGA. I'm still confused if this is the same disease or if they are two different diseases. I had elevated ANA and P-ANCA when i was diagnosed, but both have been negative for the last couple of years.. anyway, maybe vasculitis and other autoimmune kidney diseases could be a topic for a future presentation.. Appreciate your work!! ❤
In IgA vasculitis you could have IgA nephropathy, but not all IgA vasculitis people get the nephropathy.
@@peev2 thank you:)
@@jesperchristensen5888 Welcome, be healthy and happy!
Hi we are from India
I am a patient of iga nephropathy
S creatinine 1.8
Urine protein 1.8g 24 hours
Currently taken medicine
Telma-40
Atorva
Nexiiron
Please suggest best treatment
Hi Sonu ji, I do have the same problem recently diagnosed. Could you please tell me when your problem was diagnosed and how long it takes to reach the next level. Also do you seek or try alternate medicine
The side effects of these may medicine outweight their benefits! Also, arthritis and IGA seem to have the same root and cause!
Blood in the Urine could be Kidney or Bladder stones as well .Will that make you produce more Protein in the Urine ?
Blood in the urine can certainly come from bladder stones as well. Technically, it should not cause more protein in the urine though. Proteinuria comes from the kidney.
Hi. What is your opinion on
low carb diet and kidney disease.
Dr. Sean , thanks for the episode.
I have IGA Nephropathy. I weight 70 KG and my height is 5’10’’. I do regular exercise.
My body stats are good , creatine is controlled but my protein in urine is not going down it’s above 1 gram , and blood pressure is very high 150/98
My doctor has suggested the below after my kidney biopsy, I need your expert opinion as I am very worried.
Morning After Breakfast - Diovan 160 (Valsartan),
Dapaglyn 10 (dapagliflozin),
Iganef 9 (2 tablets) - Steroid
Night after dinner - Norvasc 5 mg (Amlodipine besylate),
Febustat 40 mg
I am 39 years old and started my treatment 2 months back. My recent microalbumin is 150