• IgA Nephropathy

    (Immunoglobulin A Nephropathy; Berger’s Disease)

    Definition

    IgA nephropathy is a disorder of the kidney. It may start with minor changes in the kidneys but can lead to chronic kidney disease or kidney failure. IgA Nephropathy is most common in men in their teens to late 30s but can occur in people of all ages.
    Anatomy of the Kidney
    Glomerulonephritis
    Copyright © Nucleus Medical Media, Inc.

    Causes

    IgA nephropathy is caused by a build up of the IgA protein in the kidneys. IgA proteins help the body fight infections. There are more of these proteins when you have an infection like the cold or flu.
    In IgA nephropathy, these proteins start to build up in the kidneys. The protein build up can damage the filters of the kidneys. These filters are needed to clean the blood as it passes through. If the filters are damaged the kidneys are not able to clean the blood. Minor damage to the filters will not cause any changes. The more damage to the filter the worse your health will be. IgA nephropathy can also cause some blood to leak into the urine.
    Genetics may play a role in the build up of IgA proteins in the kidney.

    Risk Factors

    Factors that increase your chance of IgA nephropathy is a family history of:

    Symptoms

    Early stages of IgA nephropathy rarely has symptoms.
    The first sign of IgA nephropathy is often blood in the urine. It often occurs after an infection like a cold. Small amounts of blood in the urine may only be detected with a test. Larger amounts of blood in the urine can make the urine a pink or cola color.
    Later stage symptoms may also include:
    • Protein in urine
    • Swelling of the hands and feet
    • Repeated upper respiratory infections
    • Intestinal disease
    • High blood pressure
    • High cholesterol
    • Fatigue
    • Muscle pain
    • Fever

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. To evaluate how well your kidneys are working your doctor may order:
    • Urine tests
    • Blood tests
    A kidney biopsy may be done if the above tests show signs of kidney problems. The biopsy will help your doctor find the cause of your kidney problems.

    Treatment

    There is no cure for IgA nephropathy. The goal of treatment is to slow damage to the kidneys. Your doctor will also make a plan to manage related symptoms, such as high blood pressure.
    Talk with your doctor about the best treatment plan for you. Treatment options include:

    Medications

    Depending on your symptoms and overall health, your doctor may suggest:
    • Medications to help control blood pressure and decrease protein loss in the urine
    • Cholesterol lowering medication
    • Corticosteroids to decrease inflammation in the body

    Dietary Changes

    Your doctor may recommend certain changes to your diet. The changes will depend on your overall health and your kidney function. Some changes may include:
      Controlling protein in the diet by limiting or avoiding:
      • Most meats and dairy products
      • Gluten—protein found in wheat, rye, barley, and oats
    • Controlling salt in the diet
    • Dietary changes to manage blood cholesterol levels
    Your doctor may also recommend certain supplements like fish oil. Talk to your doctor before starting any supplements.

    Lifestyle Changes

    Exercise can help with overall health. It can also help manage cholesterol and blood pressure.
    Don't smoke. If you smoke , quit.

    Kidney Support

    Dialysis takes over the job of the kidneys if they are not able to work well. It can not cure the kidney damage but will help you feel better and decrease symptoms like high blood pressure.
    A kidney transplant may be needed when illness has progressed and the kidneys have failed.

    Prevention

    The cause of IgA nephropathy is not clear, so there are no known steps to prevent it.
    Tell your doctor if you have a family history of IgA nephropathy. You and your doctor can watch for signs of the disease and manage issues like high blood pressure and cholesterol.

    RESOURCES

    American Kidney Fund http://www.kidneyfund.org/

    IgA Nephropathy Support Network http://www.igansupport.org/

    National Kidney and Urologic Disease Information Clearinghouse http://kidney.niddk.nih.gov

    CANADIAN RESOURCES

    The Foundation for IgA Nephropathy http://www.igan.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    Brenner B. Brenner Rector’s The Kidney . 7th ed. Philadelphia, PA: Elsevier; 2004.

    IgA nephropathy. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 10, 2011. Accessed February 28, 2013.

    IgA nephropathy. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/iganephropathy/ . Accessed February 28, 2013.

    Kumar V, Fausto N, Abbas A, eds. Robbins and Coltran. Pathologic Basis of Disease. 7th ed. Philadelphia, PA: Elsevier; 2005.

    National Kidney Foundation. IgA nephropathy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/iganeph.cfm . Accessed February 28, 2013.

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