EPA and aspirin in IgA nephropathy
Although immunoglobin A nephropathy (IgAN) is the main cause of primary glomerulonephritis, it is estimated that 1% of the population suffer from it without being diagnosed. In patients with IgAN, severe proteinuria, deteriorating kidney function and hypertension are predictors of progress to terminal kidney disease; however, when urine findings are minimal and kidney function is within normal limits, the long-term prognosis is good. Steroids and immunosuppressants have been widely used in the treatment of IgAN, which causes terminal kidney failure (sooner or later requiring renal replacement therapy), but the relationship between its beneficial effects and adverse side effects is a cause of controversy. Thus finding alternative therapies that provide lasting, global benefits is extremely important.
The main aim in treating this disease is not just improving prognosis and preventing transition to the terminal renal stage, but also preventing cardiovascular lesions, as cardiovascular disease is the cause of 45% of IgAN-related deaths. Various clinical studies have provided convincing results on the efficacy of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in the treatment of IgAN, although the clinical results do not match lab tests. However, considering the beneficial effects of eicosapentaenoic acid (EPA) on cardiovascular health and its systemic nature, its use in treating the early stages of IgAN should be studied in order to introduce it into clinical practice. Joint administration of EPA and aspirin has shown promising results that could lead to their use in place of steroid therapy. The explanation for these effects lies in the action of n-3 PUFA- derived specialist pro-resolving mediators (SPMs) and this should be clarified in future research.