Treatment of IgA Nephropathy: Leflunomide + Small Dose Steroid
In the world, glomerulonephritis is the leading cause of kidney failure. And IgA Nephropathy is the most common form of glomerulonephritis, accounting for 40% to 50% of glomerulonephritis. Within 10 to 20 years, 20% to 40% of patients with IgA Nephropathy progress to kidney failure.
Do you have IgA Nephropathy?
If you have any of the following 3 conditions, you should be suspected of IgA Nephropathy:
1. Gross hematuria occurs at the same time or in a short period of time after getting upper respiratory tract infection or tonsillitis, and the gross hematuria disappears or decreases after infection gets controlled;
2. Typical malformed erythrocyte urine (spore or spinous) with or without proteinuria;
3. Increased serum IgA value.
In addition, 50% of patients with IgA nephropathy have hypertension.
Through these characteristics, combined with age, physical signs and so on, IgA nephropathy can be roughly judged, and renal biopsy is required for the final diagnosis.
Leflunomide + small dose steroid for IgA Nephropathy
Patients with IgA nephropathy are commonly treated with ACEI/ARBs, as well as traditional Chinese medicine. Only when the 24-hour urine protein is reduced to 0.5g or less can it be safe. If the 24-hour urine protein is greater than 1 gram, the risk of renal failure will be significantly increased, and immunosuppressive drugs may be required for treatment.
Here is a very effective treatment for IgA nephropathy with minimal side effects: leflunomide + small dose steroid.
Glucocorticoid refers to steroids such as prednisone, methylprednisolone, cortisone, dexamethasone and so on. Steroids have been the mainstay of drugs for Chronic Kidney Disease since the 1950s. But because of the high side effects, the ideal way to use the steroid is in small doses.
Leflunomide, which is a very characteristic immunosuppressant, has a very significant feature of low side effects and high safety.
Leflunomide is not as powerful as other immunosuppressants, but when used well, it is also a good drug. We found that the "leflunomide + low-dose steroid" regimen is relatively safe and effective in the treatment of progressive IgA nephropathy. (low dose steroid refers to 20mg/ day of prednisone tablets, or 16mg/ day of methylprednisolone tablets).
More effective than adequate amounts of steroids
At present, many hospitals treat moderate to severe proteinuria in IgA nephropathy, and prednisone 0.6-1mg/kg is used for 4-8 weeks, and then the dosage is reduced. If the patient does not respond well to steroids (IgA nephropathy is not a steroid-sensitive nephropathy), immunosuppressive therapy should be used.
In fact, if used in conjunction with flutamide, the dose of steroids can be greatly reduced and the efficiency will be improved.
Long-term follow-up (more than 24 months) showed that kidney patients treated with the "leflunomide + low-dose steroid" regimen showed more significant decrease in urinary protein and better efficacy than those treated with sufficient steroid.
The above treatment is not suitable for all IgA Nephropathy patients. If you still have any questions on IgA Nephropathy treatment, please leave a message below or contact online doctor.
***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***