When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Nefropatia por imunoglobulina A (IgA)

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 16 Aug 2025
Last updated: 01 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • hematúria
Full details

Other diagnostic factors

  • proteinúria
  • hipertensão
  • edema
Full details

Risk factors

  • história familiar de nefropatia por imunoglobulina A
  • sexo masculino
  • idade entre 20 e 30 anos
  • ancestralidade asiática/branca/de nativos norte-americanos
  • Vasculite por IgA
  • doença hepática crônica
  • Infecção pelo vírus da imunodeficiência humana (HIV)
Full details

Diagnostic tests

1st tests to order

  • urinálise
  • microscopia e cultura de urina
  • bioquímica básica, incluindo taxa de filtração glomerular (TFG) estimada
  • níveis dos complementos C3 e C4
  • ultrassonografia renal
  • tomografia computadorizada (RUB)
  • biópsia renal
Full details

Tests to consider

  • cistoscopia flexível
  • biópsia de pele
Full details

Treatment algorithm

ONGOING

baixo risco de progressão

risco moderado de progressão

risco elevado de progressão

lesão renal aguda

Contributors

Authors

Jonathan Barratt, PhD, FRCP

The Mayer Professor of Renal Medicine

Department of Cardiovascular Sciences

University of Leicester

Honorary Consultant Nephrologist

John Walls Renal Unit

Leicester General Hospital

UK

Disclosures

JB has consultancies with Alnylam, argenx, Astellas, Calliditas, Chinook, Dimerix, Novartis, Omeros, Travere Therapeutics, Vera Therapeutics and Visterra. He is also an author of a number of references cited in this topic.

See Cheng Yeo, MBBS, M.Med (Int Med), FRCP (London), MD

Adjunct Assistant Professor

Head & Senior Consultant

Department of Renal Medicine

Tan Tock Seng Hospital

Singapore

Disclosures

SCY is an author of a reference cited in this topic.

Acknowledgements

Professor Jonathan Barratt and Dr See Cheng Yeo would like to gratefully acknowledge Dr Hani Bleibel and Dr Chike Nzerue, previous contributors to this topic.

Disclosures

HB and CN declare that they have no competing interests.

Peer reviewers

Richard Lafayette, MD

Associate Professor of Medicine

Nephrology Division

Stanford University Medical Center

Stanford

CA

Disclosures

RL declares that he has no competing interests.

Alan Salama, MA, MBBS, PhD, FRCP

Professor of Nephrology

UCL Centre for Nephrology

Royal Free Hospital

London

UK

Disclosures

AS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med. 2013 Jun 20;368(25):2402-14. Abstract

Trimarchi H, Barratt J, Cattran DC, et al; IgAN Classification Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Conference Participants. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017 May;91(5):1014-21. Abstract

Barratt J, Feehally J. Primary IgA nephropathy: new insights into pathogenesis. Semin Nephrol. 2011 Jul;31(4):349-60. Abstract

Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 clinical practice guideline for the management of glomerular diseases. Kidney Int. 2021 Oct;100(4s):S1-S276.Full text  Abstract

Lv J, Zhang H, Wong MG, et al; TESTING Study Group. Effect of oral methylprednisolone on clinical outcomes in patients with IgA nephropathy: the TESTING randomized clinical trial. JAMA. 2017 Aug 1;318(5):432-42. Abstract

Rauen T, Eitner F, Fitzner C, et al. Intensive supportive care plus immunosuppression in IgA nephropathy. N Engl J Med. 2015 Dec 3;373(23):2225-36.Full text  Abstract

Tumlin JA, Hennigar RA. Clinical presentation, natural history, and treatment of crescentic proliferative IgA nephropathy. Semin Nephrol. 2004 May;24(3):256-68. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Nefropatia por imunoglobulina A (IgA) images

  • Differentials

    • Vasculite por IgA (conhecida como púrpura de Henoch-Schönlein [PHS])
    • Doença da membrana basal glomerular fina
    • Síndrome de Alport
    More Differentials

  • Guidelines

    • KDIGO 2021 clinical practice guidelines for the management of glomerular diseases
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer