Complications
This is usually associated with persistent proteinuria and anaemia of chronic disease. Management should be aimed at slowing progression and managing complications of chronic kidney disease such as volume overload, hyperkalaemia, metabolic acidosis, hyperphosphataemia, renal osteodystrophy, hypertension, anaemia, dyslipidaemia, and sexual dysfunction.
The rate of progression to ESKD is about 1% to 2% per year from diagnosis.[37][36] Patients with sustained hypertension, persistent proteinuria, impaired kidney function, and an Oxford kidney biopsy score of M1 E1 S1 T2 are at highest risk of developing ESKD, and may develop ESKD in a significantly shorter time frame (60% of the patients in a 7-year period).[57]
Patients who develop ESKD require life-long kidney replacement therapy (dialysis or kidney transplantation) and treatment of associated complications including anaemia and osteodystrophy.
Acute kidney injury is relatively uncommon in IgAN (<5%).[96] It may occur as a result of a rapidly progressive glomerulonephritis, or heavy glomerular haematuria resulting in tubule occlusion by red blood cells. In the latter, the disease course is usually benign and kidney function returns to baseline within weeks.
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