Iga

IgA nephropathy has, in the course of two decades, become one of the most important renal diseases. Not only is it the most common form of glo merulonephritis seen in many countries, its increasing recognition by renal biopsy in this time has allowed sufficient study to conclude that it is also one of the most frequent causes of end-stage renal failure. The clinical features are diverse, and only in a minority do recurrent macroscopic hematuric episodes associated with an upper respiratory tract infection allow a confident clinical diagnosis. All clinicians, from community practitioners to general and specialist internists and surgeons, should be aware of its manifestations in patients of all ages. Its relationship with Henoch-Sch6nlein purpura is especially interesting. The discovery of IgA nephropathy has caused an explosion of interest and research. The disease itself (if indeed it can be regarded as a single entity rather than a syndrome) has been studied extensively by many groups and a synopsis is presented by several of the leaders in this clinical field. Parallel with the increased understanding of the renal disease, there has occurred similar incremental knowledge in such diverse fields as the structure and function of the glomerular mesangium, the biology of mucosal immu nity, and the IgA immune response. This book has collected essays on these topics that emphasize their importance in the rclation to the study of IgA nephropathy.

A further step towards unraveling this mysterious disease Primary IgA nephropathy has first been described as a new disease entity almost 40 years ago. This disorder, considered to be an immune-complex-mediated glomerulonephritis, is characterized by granular deposition of IgA (mainly IgA1) and C3 in the glomerular mesangial areas and is defined as nephropathy showing proliferative changes in the glomerular mesangial cells and increases in the mesangial matrices. Apart from being one of the most common types of chronic glomerulonephritis, it is also the most frequent case of end-stage renal disease. But even though continuing efforts have gradually clarified various aspects of the pathogenesis of the disease, specific treatment is not yet available. In this publication, international nephrologists and basic scientists report the most recent data on IgA nephropathy. Starting with clinical reviews on topics such as the clinico-pathological classification, new treatment approaches, and the role of renal biopsies, the focus then shifts towards basic reviews on, for example, candidate genes, the pathogenic role of IgA receptors or immune complex formation. Updates on clinical and basic advances, discussing among other things the influence of obesity or various therapeutic approaches, make up the second part of the book. Presenting up-to-date information on this still mysterious disease, the publication at hand constitutes a valuable source of information for nephrologists, general practitioners, residents and interns.

The author of this volume has studied IgA nephropathy for nearly 25 years, almost as long as primary IgA nephropathy has been recognized as a new disease. IgA nephropathy, considered to be an immune-complex-mediated glomerulonephri tis, is characterized by granular deposition of IgA (mainly IgA1) and C3 in the glomerular mesangial areas and is defined as nephropathy showing pro- liferative changes in the glomerular mesangial cells and increases in the mesangial matrices. Apart from being one of the most common types of chronic glomerulonephritis, it is also the most frequent case of end-stage renal disease. Since the pathogenesis of IgA nephropathy is still obscure, specific treatment is not yet available. Previous approaches have included tonsillectomy, anticoagulants, prednisolone, immunosuppressants, angiotensin-converting enzyme inhibitors and others. During his career, the author of this book has studied many aspects of IgA nephropathy, shedding much light on the mechanism of development and progression of this disease. He also undertook new treatments for patients and developed animal models for IgA nephropathy. The purpose of the present volume is to review the authors work on pathogenesis and treatment of the disease and to provide the most up-to-date findings on this subject, constituting a valuable source of information for nephrologists, general practitioners, residents and interns.

IgA nephropathy is the most common primary glomerulonephritis in developed countries. The primary defect lies in the abnormalities of the IgA molecule. The disease affects all ages, mainly in the young adults, and may recur in a transplanted kidney. This outstanding volume provides a comprehensive overview of the advances in this disease over the last ten years. It covers the genetics, epidemiology, clinicopathological features, pathogenesis, prognostic mechanisms, and treatment of this unique disease. Twenty-seven chapters are written by 43 experts from 13 countries; these experts have been providing forefront scientific findings to the scientific community for the last 20 years. The book covers all clinical, pathological and molecular aspects of IgA nephropathy. This is an essential source of reference for nephrologists, internists, pathologists, and molecular biologists. It is also suitable reading for graduate students or research scientists in the field of kidney diseases.

IgA nephropathy (IgAN) is one of the most common glomerular diseases world-wide. Its natural history is consistent with a clinical onset in the first decades of life. Clinical indicators of poor prognosis are proteinuria and hypertension. Angiotensin-converting enzyme-inhibitors (ACE-I) are a promising treatment, since angiotensin II playes a key role in glomerular hypertension and permselectivity and modulates mesangial and tubular cell functions.

This book discusses the latest findings on the pathogenesis and treatment of IgA nephropathy. It particularly focuses on recently recognized initiation and progression factors and the varying treatment strategies in different regions, such as Asia, Europe, and the United States. More than 40 years have passed since Dr. Jean Berger first described primary IgA nephropathy (“Nephropathy with mesangial IgA-IgG deposits”) as a new disease entity. Immunohistopathologically, IgA nephropathy is characterized by the granular deposition of IgA (IgA1) and C3 in the glomerular mesangial areas with mesangial cell proliferation and the expansion of mesangial matrices. It is clear that IgA nephropathy is one of the most common types of chronic glomerulonephritis in the world. This disease may lead to end-stage kidney disease, with its enormous economic impact on healthcare everywhere. Efforts by many investigators around the world have gradually clarified various aspects of the pathogenesis and treatment of IgA nephropathy. However, there are many controversial strategies for the treatment of patients with IgA nephropathy throughout the world, as there are several limitations for treatment in each country. This volume provides nephrologists everywhere with an overview and comparison of both global and regional findings in basic and clinical fields in IgA nephropathy. It covers genetic variation, aberrant IgA1 production, and classification etiology, guidelines, and treatment goals, with all chapters written by top international researchers.