药物相关性IgA肾病的诊疗新进展

中图分类号：R692 文献标志码：A DOI：10.7652/jdyxb202504023

ABSTRACT： Drug-assciated IgA nephropathy （DA-IgAN） is an important subtype of secondary IgA nephropathy （sIgAN），with insidiousclinical manifestationsand highly overlapping pathological features with primary IgA nephropathy（IgAN），leading to a high risk of misdiagnosis.The disease's pathogenesis iscomplex and involves a variety of drugs.Non-steroidal anti-inflammatory drugs and antibiotics were the most common in the past. Recent studies have revealed thata variety of drugs[such as tumor necrosis factor- α （TNF- α ）inhibitors，interleukin-12/ interleukin-23（IL-12/IL-23）inhibitors，immune checkpoint inhibitors（ICIs），cytotoxic T-lymphocyteassciated antigen4（CTLA-4） inhibitors，oral anticoagulants，thiourea derivatives，and anti-vascular endothelial growth factors]maytrigger oraggravate IgAN through diferent mechanisms.This article summarizes the pathogenic drugs， mechanisms，diagnosis，and treatment progressof drug-induced IgAN，providing some evidence for improved clinical diagnosis and management.

KEY WORDS：drug-induced kidney injury； IgA nephropathy （IgAN）；diagnosis and treatment；mechanism; advances

IgA肾病（IgAnephropathy，IgAN）是全球范围内最常见的原发性肾小球疾病，约占原发性肾小球肾炎的 20%～40% ，约 40% 的患者在确诊后20年内进展为终末期肾病（end-stagerenaldisease，ESRD），尤其是未接受早期治疗的患者[1-2]。（剩余16333字）