[IgA肾病慢性肾病的治疗]。

Deutsche medizinische Wochenschrift (1946) Pub Date : 2025-01-01 Epub Date: 2025-01-14 DOI:10.1055/a-2255-6329
Severin Schricker, Moritz Schanz, Jörg Latus
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引用次数: 0

摘要

本文概述了IgA肾病(IgAN)患者慢性肾脏疾病(CKD)的治疗方法。IgAN是最常见的原发性肾小球肾炎,由对异常糖基化免疫球蛋白A (IgA)抗体的自身免疫反应引起。虽然历史上认为大部分是良性的,但现在认识到,随着时间的推移,很大比例的患者会发展为透析依赖性肾脏疾病。传统的RAAS抑制剂治疗方法和新的治疗方法,如SGLT2抑制剂、内皮素受体拮抗剂和延迟释放,主要是局部作用的肠内皮质类固醇在减少蛋白尿和保持肾功能方面的作用也进行了讨论。此外,非免疫抑制选择和生活方式的改变被检查其减缓疾病进展的潜力。其他有希望的药物目前正在临床试验中,包括补体抑制剂和免疫调节剂。这些新兴疗法为将来显著改善IgAN的预后提供了希望。通过全面概述当前和潜在的未来治疗策略,本综述旨在为临床医生提供最新信息,以优化IgAN患者CKD的管理。
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[Treatment of chronic kidney disease in IgA nephropathy].

This article provides an overview of treatment approaches for chronic kidney disease (CKD) in patients with IgA nephropathy (IgAN). IgAN is the most common primary glomerulonephritis and results from an autoimmune reaction to aberrantly glycosylated immunoglobulin A (IgA) antibodies. Although historically considered largely benign, it is now recognized that a significant percentage of patients develop dialysis-dependent kidney disease over the years. Traditional treatments with RAAS inhibitors and newer therapies such as SGLT2 inhibitors, endothelin receptor antagonists, and delayed release, primarily locally acting enteric corticosteroids regarding their role in reducing proteinuria and preserving kidney function are also discussed. Additionally, non-immunosuppressive options and lifestyle modifications are examined for their potential to slow disease progression. Further promising medications are currently in clinical trials, including complement inhibitors and immunomodulators. These emerging therapies offer hope for significantly improving the prognosis of IgAN in the future. By presenting a comprehensive overview of current and potential future treatment strategies, this review aims to provide clinicians with up-to-date information to optimize the management of CKD in patients with IgAN.

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