Nephrol Dial Transplant (1993) 8: 1193-1198
© 1993 European Renal Association-European Dialysis and Transplant Association
research-article
Low-antigen-content diet in the treatment of patients with IgA nephropathy
1Istituto Patologia Medica I, University of Pisa Pisa, Italy 2Nephrology Unit, Ospedale S. Chiara Pisa, Italy
Correspondence and offprint requests to: Correspondence and offprint request to: Prof. Clodoveo Ferri, Instituto Patologia Medica, I, Via Roma, 67, 56100 Pisa, Italy
Since dietary macromolecular antigens can be involved in the pathogenesis of IgA nephropathy (IgAN), the effect of a low-antigen-content diet was evaluated in 21 patients (10 women, 11 men, mean age 27.7±10 years) with immunohistochemical findings of active IgAN. The diet was followed for a 14–24-week period (mean 18.8±6); in all cases the effects of the treatment were evaluated by clinical and serological parameters, and in 11 patients also by repeat renal biopsy.
After dietetic therapy a significant reduction of urinary proteins was recorded (P< 0.001); in particular, heavy proteinuria (>1 g/day), present in 12 cases during the 6 months preceding the treatment, was markedly reduced or disappeared in 11. At posttreatment control biopsy mesangial and parietal deposits of immunoglobulins, complement C5, fraction and fibrinogen were significantly reduced. The improvement of the objective parameters such as heavy proteinuria, a strong predictor of a poor prognosis, and of immunohistochemical alterations indicate that a low-antigen diet can positively affect patients with IgAN. These results could be ascribed to a reduction of nephritogenic food antigen input and to a putative functional restoration of the mononuclear phagocytic system.
Keywords: IgA nephropathy; proteinuria; dietetic therapy; low-antigen-content diet; secretory IgA; IgA immune complexes
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