{"id":32874,"date":"2023-05-09T16:20:22","date_gmt":"2023-05-09T09:20:22","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32874"},"modified":"2023-05-09T16:20:22","modified_gmt":"2023-05-09T09:20:22","slug":"khuyen-cao-kdigo-ve-chan-doan-dieu-tri-benh-than-iga","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/09\/khuyen-cao-kdigo-ve-chan-doan-dieu-tri-benh-than-iga\/","title":{"rendered":"Khuy\u1ebfn c\u00e1o KDIGO v\u1ec1 ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb b\u1ec7nh th\u1eadn IgA"},"content":{"rendered":"<p><strong>B\u1ec7nh th\u1eadn IgA, c\u00f2n \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn l\u00e0 b\u1ec7nh Berger&#8217;s, l\u00e0 b\u1ec7nh th\u1eadn x\u1ea3y ra khi IgA l\u1eafng \u0111\u1ecdng trong th\u1eadn, g\u00e2y vi\u00eam v\u00e0 ph\u00e1 h\u1ee7y th\u1eadn. Khuy\u1ebfn c\u00e1o c\u1ee7a KDIGO 2021 v\u1ec1 qu\u1ea3n l\u00fd b\u1ec7nh c\u1ea7u th\u1eadn trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0a ra c\u00e1c th\u00f4ng tin khoa h\u1ecdc d\u1ef1a tr\u00ean ph\u00e2n t\u00edch g\u1ed9p c\u00e1c y v\u0103n v\u1ec1 ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n, ti\u00ean l\u01b0\u1ee3ng v\u00e0 h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb b\u1ec7nh th\u1eadn IgA cho b\u00e1c s\u0129 l\u00e2m s\u00e0ng.\u00a0<\/strong><\/p>\n<h2>1. Khuy\u1ebfn c\u00e1o c\u1ee7a KDIGO v\u1ec1 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh th\u1eadn IgA.<\/h2>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/benh-iga-co-nguy-hiem-khong-dieu-tri-nhu-nao\/\">B\u1ec7nh th\u1eadn IgA<\/a> (IgAN) ch\u1ec9 c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n nh\u1edd <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/chi-dinh-sinh-thiet-duoi-huong-dan-sieu-am\/\">sinh thi\u1ebft th\u1eadn<\/a>. \u0110\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 gi\u1ea3i ph\u1eabu b\u1ec7nh d\u1ef1a tr\u00ean thang \u0111i\u1ec3m MEST-C (bao g\u1ed3m t\u0103ng m\u1eadt \u0111\u1ed9 t\u1ebf b\u00e0o gian m\u1ea1ch v\u00e0 trong n\u1ed9i m\u1ea1c, x\u01a1 chai t\u1eebng \u0111o\u1ea1n, x\u01a1 h\u00f3a kho\u1ea3ng k\u1ebd\/teo \u1ed1ng th\u1eadn) theo ph\u00e2n lo\u1ea1i Oxford c\u1ea3i ti\u1ebfn. Kh\u00f4ng c\u00f3 x\u00e9t nghi\u1ec7m d\u1ea5u \u1ea5u huy\u1ebft thanh ho\u1eb7c n\u01b0\u1edbc ti\u1ec3u cho IgAN.<\/p>\n<p>C\u1ea7n t\u00ecm nguy\u00ean nh\u00e2n th\u1ee9 ph\u00e1t cho t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n IgAN tr\u01b0\u1edbc khi \u0111\u00e1nh gi\u00e1 l\u00e0 IgAN v\u00f4 c\u0103n. \u0110\u00f3 l\u00e0 vi\u00eam m\u1ea1ch m\u00e1u IgA, IgAN th\u1ee9 ph\u00e1t do:<\/p>\n<ul>\n<li>Nhi\u1ec5m virus (HIV, vi\u00eam gan B).<\/li>\n<li><a href=\"https:\/\/vinmecdr.com\/tiep-can-viem-dai-trang-man-cap-nhat-tu-cac-khuyen-cao\/\">B\u1ec7nh l\u00fd ru\u1ed9t vi\u00eam.\u00a0<\/a><\/li>\n<li>B\u1ec7nh l\u00fd t\u1ef1 mi\u1ec5n.<\/li>\n<li>X\u01a1 gan.<\/li>\n<li>Vi\u00eam c\u1ea7u th\u1eadn li\u00ean quan nhi\u1ec5m tr\u00f9ng, IgA \u01b0u th\u1ebf.<\/li>\n<\/ul>\n<h2>2. Ti\u00ean l\u01b0\u1ee3ng cho b\u1ec7nh th\u1eadn IgA nguy\u00ean ph\u00e1t.<\/h2>\n<p>Ph\u00e2n t\u1ea7ng nguy c\u01a1 b\u1ec7nh nh\u00e2n d\u1ef1a v\u00e0o d\u1eef ki\u1ec7n l\u00e2m s\u00e0ng v\u00e0 m\u00f4 h\u1ecdc t\u1ea1i th\u1eddi \u0111i\u1ec3m sinh thi\u1ebft.<\/p>\n<p>International IgAN Prediction Tool l\u00e0 c\u00f4ng c\u1ee5 c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ec3 t\u00ednh nguy c\u01a1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh v\u00e0 \u0111\u01b0a ra th\u00f4ng tin h\u1ed7 tr\u1ee3 b\u1ec7nh nh\u00e2n l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>Ch\u1ec9 c\u00f3 2 y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng cho IgAN l\u00e0 eGFR v\u00e0 \u0111\u1ea1m ni\u1ec7u.<\/p>\n<h2>3. Khuy\u1ebfn c\u00e1o KDIGO v\u1ec1 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh th\u1eadn IgA.<\/h2>\n<p>C\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb cho t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n IgAN kh\u00f4ng c\u00f3 c\u00e1c bi\u1ebfn th\u1ec3 c\u1ee7a IgAN nguy\u00ean ph\u00e1t. \u0110i\u1ec1u tr\u1ecb bao g\u1ed3m:<\/p>\n<ul>\n<li>Qu\u1ea3n l\u00fd ban \u0111\u1ea7u t\u1eadp trung v\u00e0o t\u1ed1i \u01b0u \u0111i\u1ec1u tr\u1ecb n\u00e2ng \u0111\u1ee1.<\/li>\n<li>\u0110\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch v\u00e0 \u0111\u01b0a ra h\u01b0\u1edbng can thi\u1ec7p khi c\u1ea7n thi\u1ebft.<\/li>\n<li>Gi\u00e1o d\u1ee5c thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng, g\u1ed3m c\u00e1c th\u00f4ng tin v\u1ec1 h\u1ea1n ch\u1ebf mu\u1ed1i, gi\u1ea3m h\u00fat thu\u1ed1c, ki\u1ec3m so\u00e1t c\u00e2n n\u1eb7ng, t\u1eadp th\u1ec3 d\u1ee5c.<\/li>\n<li>C\u00e1c bi\u1ebfn th\u1ec3 c\u1ee7a IgAN g\u1ed3m: th\u1ec3 sang th\u01b0\u01a1ng t\u1ed1i thi\u1ec3u (MCD) c\u00f3 l\u1eafng \u0111\u1ecdng IgA, IgAN k\u00e8m t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p (AKI), v\u00e0 IgAN k\u00e8m vi\u00eam c\u1ea7u th\u1eadn ti\u1ebfn tri\u1ec3n nhanh (RPGN) c\u1ea7n \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u ngay l\u1eadp t\u1ee9c.<\/li>\n<\/ul>\n<p>KDIGO khuy\u1ebfn c\u00e1o t\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh IgA n\u00ean \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p. N\u1ebfu \u0111\u1ea1m ni\u1ec7u &gt;0.5g\/ng\u00e0y, khuy\u1ebfn c\u00e1o kh\u1edfi \u0111\u1ea7u li\u1ec7u ph\u00e1p d\u00f9ng \u1ee9c ch\u1ebf men chuy\u1ec3n (ACEi) ho\u1eb7c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin II (ARB).<\/p>\n<p>T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ea1m ni\u1ec7u &gt;0.5g\/ng\u00e0y, b\u1ea5t k\u1ec3 c\u00f3 t\u0103ng huy\u1ebft \u00e1p hay kh\u00f4ng \u0111\u1ec1u c\u1ea7n \u0111i\u1ec1u tr\u1ecb v\u1edbi ACEi ho\u1eb7c ARB.<\/p>\n<h3>3.1. Khuy\u1ebfn c\u00e1o v\u1ec1 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n IgAN nguy c\u01a1 cao ti\u1ebfn tri\u1ec3n b\u1ec7nh th\u1eadn m\u1ea1n khi \u0111ang \u0111i\u1ec1u tr\u1ecb n\u00e2ng \u0111\u1ee1.<\/h3>\n<p>\u0110i\u1ec1u tr\u1ecb t\u1ed1i \u01b0u n\u00e2ng \u0111\u1ee1 trong 3 th\u00e1ng g\u1ed3m: (1) Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p, (2) D\u00f9ng t\u1edbi li\u1ec1u t\u1ed1i \u0111a dung n\u1ea1p c\u1ee7a ACEi\/ARB, (3) <a href=\"https:\/\/vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/cach-kiem-soat-tang-huyet-ap-ma-khong-can-dung-thuoc\/\">Thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng<\/a>, (4) <a href=\"https:\/\/vinmecdr.com\/uoc-tinh-va-phan-tang-nguy-co-tim-mach-trong-phong-ngua-tien-phat\/\">\u0110\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch v\u00e0 can thi\u1ec7p.<\/a><\/p>\n<ul>\n<li>IgAN nguy c\u01a1 cao ti\u1ebfn tri\u1ec3n b\u1ec7nh th\u1eadn m\u1ea1n \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 c\u00f3 \u0111\u1ea1m ni\u1ec7u &gt;0.75 &#8211; 1g\/ng\u00e0y khi \u0111\u00e3 ch\u0103m s\u00f3c n\u00e2ng \u0111\u1ee1 t\u1ed1i \u01b0u trong 90 ng\u00e0y.<\/li>\n<li>Tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch. C\u1ea7n \u0111\u00e1nh gi\u00e1 nguy c\u01a1 b\u1ec7nh nh\u00e2n nhi\u1ec1u th\u1eddi \u0111i\u1ec3m v\u00e0 c\u00f3 th\u1ec3 thay \u0111\u1ed5i \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>Gi\u1ea3m \u0111\u1ea1m ni\u1ec7u d\u01b0\u1edbi 1g\/ng\u00e0y l\u00e0 d\u1ea5u hi\u1ec7u cho th\u1ea5y c\u1ea3i thi\u1ec7n k\u1ebft c\u1ee5c th\u1eadn trong IgAN, v\u00e0 n\u00ean \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>KDIGO khuy\u1ebfn c\u00e1o b\u1ec7nh nh\u00e2n nguy c\u01a1 cao b\u1ec7nh th\u1eadn m\u1ea1n (CKD) ti\u1ebfn tri\u1ec3n d\u00f9 \u0111i\u1ec1u tr\u1ecb n\u00e2ng \u0111\u1ee1 c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc li\u1ec7u ph\u00e1p corticosteroid trong 6 th\u00e1ng. C\u1ea7n th\u1ea3o lu\u1eadn v\u1edbi b\u1ec7nh nh\u00e2n v\u1ec1 nguy c\u01a1 \u0111\u1ed9c t\u00ednh thu\u1ed1c t\u00edch l\u0169y, \u0111\u1eb7c bi\u1ec7t khi eGFR &lt;50 ml\/min\/ 1.73 m<sup>2<\/sup><\/li>\n<\/ul>\n<p>Kh\u00f4ng \u0111i\u1ec1u tr\u1ecb glucocorticoid cho IgAN th\u1ee9 ph\u00e1t. L\u1ee3i \u00edch c\u1ee7a glucocorticoid trong IgAN kh\u00f4ng r\u00f5 r\u00e0ng n\u00ean c\u1ea7n th\u1eadn tr\u1ecdng ho\u1eb7c tr\u00e1nh trong m\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng sau:<\/p>\n<ul>\n<li>eGFR&lt;30ml\/ph\u00fat\/1.73m2.<\/li>\n<li>K\u00e8m \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/li>\n<li>B\u00e9o ph\u00ec, BMI &gt;30.<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng ti\u1ec1m \u1ea9n (vi\u00eam gan B, lao).<\/li>\n<li>B\u1ec7nh th\u1ee9 ph\u00e1t (x\u01a1 gan).<\/li>\n<li>Lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng ho\u1ea1t \u0111\u1ed9ng.<\/li>\n<li>B\u1ec7nh t\u00e2m th\u1ea7n ch\u01b0a ki\u1ec3m so\u00e1t.<\/li>\n<li>Lo\u00e3ng x\u01b0\u01a1ng n\u1eb7ng.<\/li>\n<\/ul>\n<h3>3.2. M\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng \u0111\u1eb7c bi\u1ec7t.<\/h3>\n<p>IgAN k\u00e8m h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 (NS). M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u00edt g\u1eb7p, IgAN c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n NS. Khi \u0111\u00f3, s\u1ef1 l\u1eafng \u0111\u1ecdng IgA gian m\u1ea1ch c\u00f3 th\u1ec3 gi\u1ed1ng v\u1edbi b\u1ec7nh l\u00fd ch\u00e2n gi\u1ea3 trong MCD. N\u1ebfu sinh thi\u1ebft th\u1eadn cho h\u00ecnh \u1ea3nh vi\u00eam c\u1ea7u th\u1eadn t\u0103ng sinh gian m\u1ea1ch, c\u00f3 th\u1ec3 qu\u1ea3n l\u00fd theo h\u01b0\u1edbng b\u1ec7nh nh\u00e2n nguy c\u01a1 cao ti\u1ebfn tri\u1ec3n CKD khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u00e2ng \u0111\u1ee1 t\u1ed1i \u01b0u. IgAN c\u00f3 th\u1ec3 g\u1eb7p ti\u1ec3u \u0111\u1ea1m ng\u01b0\u1ee1ng h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0 kh\u00f4ng k\u00e8m h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0, n\u00f3 th\u01b0\u1eddng g\u1ee3i \u00fd k\u00e8m theo FSGS (\u0111\u1eb7c bi\u1ec7t n\u1ebfu b\u1ec7nh nh\u00e2n b\u00e9o ph\u00ec, t\u0103ng huy\u1ebft \u00e1p kh\u00f4ng ki\u1ec3m so\u00e1t) ho\u1eb7c xu\u1ea5t hi\u1ec7n x\u01a1 chai c\u1ea7u th\u1eadn khu tr\u00fa v\u00e0 x\u01a1 h\u00f3a \u1ed1ng th\u1eadn m\u00f4 k\u1ebd.<\/p>\n<p>IgAN k\u00e8m AKI: AKI c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n IgAN trong b\u1ec7nh c\u1ea3nh \u0111\u00e1i m\u00e1u \u0111\u1ea1i th\u1ec3, th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p tr\u00ean. Sinh thi\u1ebft th\u1eadn l\u1eb7p l\u1ea1i n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng th\u1eadn trong v\u00f2ng 2 tu\u1ea7n sau khi h\u1ebft \u0111\u00e1i m\u00e1u. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y n\u00ean \u0111\u01b0\u1ee3c t\u1eadp trung \u0111i\u1ec1u tr\u1ecb n\u00e2ng \u0111\u1ee1 cho AKI.<\/p>\n<p>IgAN k\u00e8m RPGN: Vi\u00eam c\u1ea7u th\u1eadn ti\u1ebfn tri\u1ec3n nhanh \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 khi GFR gi\u1ea3m h\u01a1n 50% trong v\u00f2ng 3 th\u00e1ng v\u00e0 khi c\u00e1c nguy\u00ean nh\u00e2n thay \u0111\u1ed5i \u0111\u01b0\u1ee3c nh\u01b0 ng\u1ed9 \u0111\u1ed9c thu\u1ed1c, t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p tr\u01b0\u1edbc th\u1eadn, sau th\u1eadn \u0111\u00e3 \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb. C\u1ea7n sinh thi\u1ebft th\u1eadn \u1edf nh\u1eefng ca n\u00e0y v\u00e0 th\u01b0\u1eddng cho h\u00ecnh \u1ea3nh t\u0103ng sinh t\u1ebf b\u00e0o n\u1ed9i mao m\u1ea1ch, gian m\u1ea1ch, v\u00e0 nhi\u1ec1u c\u1ea7u th\u1eadn b\u1ecb t\u1ed5n th\u01b0\u01a1ng li\u1ec1m, x\u01a1 h\u00f3a khu tr\u00fa.\u00a0 B\u1ec7nh nh\u00e2n IgAN ti\u1ebfn tri\u1ec3n nhanh c\u1ea7n \u0111i\u1ec1u tr\u1ecb cyclophosphamide v\u00e0 glucocorticoid.<\/p>\n<p>IgAN \u1edf tr\u1ebb em:<\/p>\n<ul>\n<li>Tr\u1ebb em \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 d\u01b0\u1edbi 18 tu\u1ed5i.<\/li>\n<li>\u0110\u00e1i m\u00e1u \u0111\u1ea1i th\u1ec3 th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em h\u01a1n ng\u01b0\u1eddi l\u1edbn, gi\u00fap ch\u1ea9n \u0111o\u00e1n s\u1edbm h\u01a1n.<\/li>\n<li>Tr\u1ebb em th\u01b0\u1eddng c\u00f3 eGFR cao h\u01a1n, b\u00e0i xu\u1ea5t protein ni\u1ec7u th\u1ea5p h\u01a1n v\u00e0 \u0111\u00e1i m\u00e1u nhi\u1ec1u h\u01a1n ng\u01b0\u1eddi l\u1edbn l\u00fac ch\u1ea9n \u0111o\u00e1n.<\/li>\n<li>Sinh thi\u1ebft th\u1eadn: th\u01b0\u1eddng th\u1ef1c hi\u1ec7n khi c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u00e1i m\u00e1u, ti\u1ec3u \u0111\u1ea1m, C3 b\u00ecnh th\u01b0\u1eddng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n, \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 vi\u00eam, ho\u1ea1i t\u1eed.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb: c\u00f3 b\u1eb1ng ch\u1ee9ng m\u1ea1nh cho th\u1ea5y hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u1ee7a ACEi\/ARB \u1edf tr\u1ebb em. T\u1ea5t c\u1ea3 tr\u1ebb c\u00f3 proteinuria &gt;200 mg\/d ho\u1eb7c PCR &gt;200 mg\/g (&gt;0.2 g\/g [20 mg\/mmol]) n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ACEi\/ARB, k\u00e8m ch\u1ebf \u0111\u1ed9 \u0103n \u00edt Na, ki\u1ec3m so\u00e1t l\u1ed1i s\u1ed1ng t\u1ed1i \u01b0u v\u00e0 ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p.<\/li>\n<li>Ch\u1ec9 \u0111\u1ecbnh thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u1edf tr\u1ebb em r\u1ed9ng r\u00e3i h\u01a1n ng\u01b0\u1eddi l\u1edbn, v\u1edbi proteinuria &gt;1 g\/d ho\u1eb7c PCR &gt;1 g\/g th\u01b0\u1eddng d\u00f9ng 4 tu\u1ea7n li\u1ec1u 1\u20132 mg\/kg\/d\u00a0 prednisolone u\u1ed1ng sau \u0111\u00f3 gi\u1ea3m li\u1ec1u d\u00f9ng trong 4 &#8211; 6 th\u00e1ng.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Ngu\u1ed3n:<\/strong><\/p>\n<p>KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases. Kidney Int. 2021;100(4S):S1\u2013S276.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh th\u1eadn IgA, c\u00f2n \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn l\u00e0 b\u1ec7nh Berger&#8217;s, l\u00e0 b\u1ec7nh th\u1eadn x\u1ea3y ra khi IgA l\u1eafng \u0111\u1ecdng trong th\u1eadn, g\u00e2y vi\u00eam v\u00e0 ph\u00e1 h\u1ee7y th\u1eadn. 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