IgA nephropathy is a common disease of the urinary tract in children. The disease can start suddenly after a fever, with hematuria and proteinuria visible to the naked eye, thus establishing the diagnosis; more often it starts insidiously, and is often detected during physical examinations, or when doing urine tests because of other diseases, and if it is taken seriously by parents and reviewed regularly, the prognosis is better; if parents do not pay enough attention, some children will gradually develop aggravation of hematuria and proteinuria, swelling, hypertension, and even hypertension. Even the appearance of renal hypofunction, in serious cases lead to uremia, endangering the life of the child. Because the disease is insidious in many cases, the child will not show any other abnormalities because of urine abnormalities, so it is easy to miss the diagnosis. In some developed countries, routine urine tests are done regularly for children so that children with urine abnormalities are detected in a timely manner. Therefore, we strongly urge to screen children for urine routine at birth, when they enter nursery school, or when they start elementary school. What IgA nephropathy IgA nephropathy is a kidney disease in which IgA deposits are predominantly found in the glomerular tract area. It can have manifestations such as hematuria, proteinuria, hypertension, swelling, and decreased renal function. The disease is divided into primary IgA nephropathy and secondary IgA nephropathy, generally in pediatrics mostly primary IgA nephropathy, if there is no special instructions, the said IgA nephropathy is also referred to primary IgA nephropathy. Why do children get IgA nephropathy Since IgA nephropathy is said to be the deposition of IgA in the glomerular thylakoid region, how is this immunoglobulin deposited into the glomerulus? We say that there are two reasons for this consequence: one is infection, especially respiratory and gastrointestinal infections, which can increase the production of IgA in the blood; the other reason is that the child’s physique is special, and what is special about it? It is widely recognized that such children produce more IgA than other children after infection, or that the liver is less able to clear IgA, or that the kidneys have a special structure that makes it easier to network IgA, or that IgA has a special structure that makes it easier to deposit in the kidneys. Almost every child will have one kind of infection or another, but very few children will develop IgA nephropathy. In other words, only children with special constitution and respiratory or gastrointestinal infections may have IgA deposited into the glomerulus, leading to IgA nephropathy. How to treat IgA nephropathy Regarding the treatment of this disease, it is important to pay attention to two aspects, one is to control the current kidney disease and the other is to prevent the development of new kidney damage; the second issue is often more important and most easily neglected. If a child has severe hematuria, proteinuria or other manifestations of kidney disease, it indicates that a new IgA-mediated immune injury has occurred in the kidney, and it is this immune response that causes hematuria and proteinuria; in treatment is to suppress this immune response, whether these immunosuppressive drugs are needed, and the type and intensity of immunosuppressive drugs used, depends on the severity of the disease; if the child has carnal hematuria and massive proteinuria, it is necessary to actively take methylprednisolone shock therapy, if simple microscopic hematuria, immunosuppressants are not needed; in addition to hormones and immunosuppressants, drugs that nourish the kidneys, improve renal microcirculation, and other supportive therapies will also be used as adjuvant medications to treat IgA nephropathy in children. A distinctive feature of this disease is that the disease may worsen whenever it encounters infection, so it is important to prevent infection; you can take some immunity-boosting drugs to prevent the occurrence of infection, and of course, life care, such as drinking water regularly, washing face, brushing teeth, washing buttocks, and adding a piece of clothing according to the temperature are important. The relationship between chronic infection foci and IgA nephropathy The complete removal of chronic infection foci is of great clinical importance for children with IgA nephropathy. It is necessary to find and treat chronic infections, such as dental caries, chronic tonsillitis, sinusitis, etc., which may not be given enough attention by general practitioners and parents and friends. By chronic foci of infection, it means that these places always have some residual bacteria that cause disease, which can normally be free of inflammation, and once the child’s resistance decreases, these bacteria will take advantage of the situation, commit crimes, and multiply to cause local inflammation, often leading to aggravation of hematuria and proteinuria. The repeated occurrence of this condition makes it easy for IgA nephropathy to gradually worsen, and if not handled properly, this is an important and common cause of renal failure.