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Assessing the gastrointestinal (GI) system is a complex process that begins with collecting subjective data. This data, collected through patient interviews, provides crucial insights into the patient's health history, perception patterns, and lifestyle habits, all contributing significantly to GI health.
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Clinical Practice Patterns in IgA Nephropathy: A Global Questionnaire-Based Survey.

Bhavik Bansal1, Amritesh Grewal1, Boon Wee Teo2

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|December 18, 2023
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Summary

IgA nephropathy management varies globally, with consensus on renin-angiotensin-aldosterone system blockade but differences in supportive therapies and immunosuppression. Clinical trial enrollment for IgAN is low, especially in lower-middle income countries.

Keywords:
IgA nephropathyKDIGO guidelineschronic kidney diseaseclinical practice guidelinesproteinuria

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Area of Science:

  • Nephrology
  • Immunology
  • Clinical Medicine

Background:

  • IgA nephropathy (IgAN) is a common kidney disease with varying ethnic phenotypes.
  • Understanding global management strategies is crucial for standardizing IgAN care.

Purpose of the Study:

  • To investigate worldwide management practices for IgA nephropathy.
  • To identify variations in treatment approaches among nephrologists globally.

Main Methods:

  • A global, two-step online survey was administered to nephrologists.
  • The survey focused on diagnostic criteria, supportive treatments, and immunosuppressive strategies for IgAN.

Main Results:

  • Most nephrologists use renin-angiotensin-aldosterone system (RAAS) blockade (97.2%) and consider proteinuria (87.9%) and eGFR decline (78.7%) for immunosuppression.
  • Significant regional differences exist in the use of supportive therapies like SGLT2 inhibitors and in clinical trial enrollment (30.4% globally, 8.1% in LMICs).
  • Corticosteroids are the primary immunosuppression (89.1%), with mycophenolate mofetil used for resistant cases (49.3%).

Conclusions:

  • While RAAS blockade and blood pressure control are standardized, IgAN management shows heterogeneity in supportive care and immunosuppression initiation.
  • Enrollment in clinical trials for novel IgAN treatments is limited, particularly in lower-middle income countries, highlighting a gap in accessing advanced therapies.