Supportive care in IgA nephropathy rests on RAS blockade, blood pressure control and lifestyle measures, with SGLT2 inhibitors increasingly added for kidney protection.
Patients with persistent proteinuria despite optimised supportive care are those considered for targeted therapies.
- Titrate ACE inhibitor or ARB to the maximum tolerated dose.
- Control blood pressure tightly, to the systolic target your guideline sets, where tolerated.
- Measure proteinuria with UPCR or 24-hour urine to track response.
- Address salt intake, smoking and weight.
Why it matters
Targeted therapies are added on top of supportive care, and their trials assumed it was optimised.
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