Patients Xiao Li and Xiao Wang were both diagnosed with IgA nephropathy. Xiao Li’s kidney function has been stable at normal level, while Xiao Wang’s kidney function has gradually deteriorated and eventually required dialysis treatment. Why some patients then progressive deterioration? 1, the culprit causes of deterioration of IgA nephropathy Many factors are related to the deterioration of IgA nephropathy, such as male, old age, hematuria, proteinuria, severe damage to kidney pathology, hypertension, hypoalbuminemia, hyperuricemia, nephrotoxic drugs and food, infection, etc. The main factors are: infection, nephrotoxic drugs and foods, massive proteinuria (urine protein > 1.0 g/day), hypoalbuminemia (serum albumin < 35 g/L), hyperuricemia (serum uric acid > 430 umol/L) and hypertension (blood pressure > 140/90 mmHg). 2, how to prevent the deterioration of IgA nephropathy So many factors are related to the deterioration of IgA nephropathy, how will we uncover these culprits and prevent the deterioration of IgA nephropathy? (1) Prevention and treatment of infection Patients with IgA nephropathy can prevent infection by paying attention to personal hygiene, preventing cold and keeping warm, and enhancing physical fitness with proper exercise. If an infection occurs, it should be treated in the nephrology department of a regular hospital as soon as possible; for long-term chronic infections should be treated as far as possible to remove the “time bomb” hidden in the body. (2) Avoid using nephrotoxic drugs Patients with IgA should follow up regularly at a regular hospital, and should first consult a nephrologist when using new drugs or adjusting their medication, rather than taking a drug on their own, especially a “cure-all” Chinese medicine, or adjusting the dose of the drug on their own. (3) Regular treatment and control of proteinuria, reduce proteinuria methods: ① Diet: low salt diet can reduce the glomerular filtration rate, thereby reducing the filtration of urinary protein; excessive protein intake increases the filtration of glomerular protein, thereby increasing renal damage, so patients with renal impairment need to limit the intake of protein. (2) Drug therapy: commonly used drugs include angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, hormones, immunosuppressants, etc. Drug therapy takes a long time and requires continuous and regular use of drugs, and changing or stopping drugs by oneself will obviously affect the therapeutic effect. ③ Improving hypoalbuminemia: controlling proteinuria is the primary measure to improve hypoproteinemia. If protein intake is blindly increased without controlling proteinuria, it will instead increase urinary protein excretion and aggravate renal damage. Prevent hyperuricemia: The most important thing to prevent elevated blood uric acid is to reduce uric acid production, reduce the intake of seafood, beer, broth, nuts and other foods containing a lot of purines, and consume more vegetables and fruits. Allopurinol can be used to inhibit the production of uric acid when gout is not attacked; at the same time, alkaline substances such as soda and sodium bicarbonate can be consumed to promote the excretion of uric acid. ⑤ Treatment of hypertension: good control of blood pressure can reduce damage to the heart, cerebrovascular, kidney and other organs, how to control blood pressure? What level of blood pressure needs to be controlled? The following methods can be chosen: improve lifestyle: appropriate exercise, adequate sleep, low-salt diet, quit smoking, etc.; the use of antihypertensive drugs: long-term, regular use of antihypertensive drugs, while according to the specific circumstances of the patient’s choice of drugs, the recommended combination, small doses of antihypertensive drugs to achieve optimal antihypertensive effect, and minimal side effects, the current belief that blood pressure should be controlled at 130/80mmHg more ideal, too low, too high The blood pressure is not good for the organism.