Lifestyle Modifications for IgA Nephropathy, Immunoglobulin A (IgA) Nephropathy, Glomerulonephritis: скачать в хорошем качестве

Lifestyle Modifications for IgA Nephropathy, Immunoglobulin A (IgA) Nephropathy, Glomerulonephritis:

A 21-year-old man with well-documented IgA nephropathy, controlled blood pressure, and active strength training habits presents for follow-up before college. He is focused on maximizing muscle gains and maintaining kidney health while managing concurrent immunodeficiency and a complex medical history. What clinical factors should be considered when advising lifestyle modifications in this scenario? How can potential risks to renal function be identified in patients balancing fitness goals and chronic kidney disease? VIDEO INFO Category: Lifestyle Modifications for IgA Nephropathy, Immunoglobulin A (IgA) Nephropathy, Glomerulonephritis: Causes, Diagnosis, and Management, Nephrology: Kidney Disease Diagnosis and Management Difficulty: Hard - Advanced level - Challenges experienced practitioners Question Type: Contraindications Case Type: Routine Visit - Standard clinical encounter in outpatient setting Explore more ways to learn on this and other topics by going to https://endlessmedical.academy/auth?h... QUESTION A 21-year-old man with biopsy-proven IgA nephropathy (Oxford M1 E0 S0 T0 C0) diagnosed 8 months ago presents for a scheduled nephrology follow-up before returning to college. He is asymptomatic and requests coaching on diet and training for strength gains during the semester. He lifts 5 days per week, uses a caffeinated pre-workout without creatine, and frequently eats commercially prepared protein bars. He smokes 0.5 pack/day and is in counseling to quit.... OPTIONS A. Initiate a ketogenic bulk targeting 1.8-2.2 g/kg/day protein (about 137-167 g/day at 76 kg) for 6-8 weeks while continuing current therapy; this protein load exceeds the greater than 1.3 g/kg/day avoidance threshold in proteinuric CKD and is contraindicated in IgA nephropathy. B. Adopt a plant-forward Mediterranean-style eating pattern with approximately 0.9-1.0 g/kg/day protein, careful label reading for hidden sodium, and a sodium cap near 2 g/day; continue lisinopril and dapagliflozin and monitor albuminuria quarterly. C. Perform 150 minutes/week of moderate-intensity aerobic activity plus two 20-30 minute resistance sessions weekly; maintain usual hydration habits, avoid NSAIDs, and standardize first-morning urine checks monthly if macroscopic hematuria follows vigorous workouts. D. Temporarily raise protein to 1.2-1.3 g/kg/day during a 6-week hypertrophy block while maintaining RAAS/SGLT2 therapy with monthly urine albumin-to-creatinine monitoring, then return to approximately 0.8 g/kg/day thereafter. CORRECT ANSWER A. Initiate a ketogenic bulk targeting 1.8-2.2 g/kg/day protein (about 137-167 g/day at 76 kg) for 6-8 weeks while continuing current therapy; this protein load exceeds the greater than 1.3 g/kg/day avoidance threshold in proteinuric CKD and is contraindicated in IgA nephropathy. EXPLANATION The clearly contraindicated lifestyle move in proteinuric IgA nephropathy is a ketogenic bulk with very high protein at 1.8-2.2 g/kg/day. Per contemporary CKD and IgA nephropathy guidance, adults with persistent albuminuria should avoid protein intake above 1.3 g/kg/day because higher intake increases intraglomerular pressure, proteinuria, and the risk of progression, counteracting the benefits of RAAS and SGLT2 therapy. For a 76-kg patient, 1.8-2.2 g/kg/day equals about 137-167 g/day-well beyond the avoidance threshold-so it is contraindicated. By contrast, a plant-forward Mediterranean-style pattern with approximately 0.9-1.0 g/kg/day protein and a sodium cap near 2 g/day aligns with supportive care.... Further reading: Links to sources are provided for optional further reading only. The questions and explanations are independently authored and do not reproduce or adapt any specific third-party text or content. --------------------------------------------------- Our cases and questions come from the https://EndlessMedical.Academy quiz engine - multi-model platform. Each question and explanation is forged by consensus between multiple top AI models (i.e. Open AI GPT, Claude, Grok, etc.), with automated web searches for the latest research and verified references. Calculations (e.g. eGFR, dosages) are checked via code execution to eliminate errors, and all references are reviewed by several AIs to minimize hallucinations. Important note: This material is entirely AI-generated and has not been verified by human experts; despite stringent consensus checks, perfect accuracy cannot be guaranteed. Exercise caution - always corroborate the content with trusted references or qualified professionals, and never apply information from this content to patient care or clinical decisions without independent verification. Clinicians already rely on AI and online tools - myself included - so treat this content as an additional focused aid, not a replacement for proper medical education. Visit https://endlessmedical.academy for more AI-supported resources and cases. This material can not be treated as medical advi