Update on immunoglobulin a nephropathy. Part II: Clinical, diagnostic and therapeutical aspects

Table 4 Supportive therapy of immunoglobulin a nephropathy

Level 1	Control blood pressure (sitting systolic BP in the 120 s)
	ACE inhibitor or ARB therapy with up-titration of dosage or combination ACE inhibitor and ARB therapy
Level 2	Control protein intake
	Restrict NaCl intake/institute diuretic therapy
	Control each component of the metabolic syndrome
	Aldosterone antagonist therapy
	Beta-blocker therapy
	Smoking cessation
Other measures	Allopurinol therapy
	Empiric NaHCO3 therapy, independent of whether metabolic acidosis is present or not
	Avoid NSAIDs altogether, or no more than once or twice weekly at most
	Avoid prolonged severe hypokalemia
	Avoid phosphate cathartics
	Ergocalciferol therapy to correct vitamin D deficiency
	Control hyperphosphatemia and hyperparathyroidism

ACE: Angiotensin-converting enzyme; ARB: Angiotensin receptor blocker; NaCl: Sodium chloride; NaHCO₃: Sodium bicarbonate; NSAID: Non-steroidal anti-inflammatory drug.