What is IgA Nephropathy?

Kid­neys, although small and often over­looked com­pared to some of our oth­er vital organs, play a crit­i­cal role in fight­ing off infec­tions and main­tain­ing a healthy bal­ance in your body every day. One of their pri­ma­ry func­tions is to act as a fil­tra­tion sys­tem for your blood. Each kid­ney con­tains tiny blood ves­sels called glomeruli that sep­a­rate waste and remove excess water and oth­er con­t­a­m­i­nants from your blood. After pass­ing through your kid­neys, the fil­tered, ​“clean” blood re-enters your blood­stream and the waste is removed from your body through urine.

In addi­tion to pre­vent­ing infec­tion through this blood fil­tra­tion process, your immune sys­tem releas­es an anti­body called, immunoglob­u­lin A (IgA). While IgA plays an impor­tant role in boost­ing your abil­i­ty to fight ill­ness, in some peo­ple, IgA may accu­mu­late in the kid­neys, becom­ing logged in the glomeruli. This abnor­mal buildup of IgA in the kid­neys is known as IgA nephropa­thy (for­mer­ly called Berg­er’s Disease).

Over time, the accu­mu­la­tion of IgA in the kid­neys can cause inflam­ma­tion and make it more dif­fi­cult for your kid­ney to fil­ter waste and in some cas­es, lead to kid­ney damage.

The exact cause of this kid­ney dis­ease is unclear. Stud­ies have indi­cat­ed there may be a genet­ic link and oth­er envi­ron­men­tal fac­tors that may increase an indi­vid­u­al’s like­li­hood of devel­op­ing the dis­ease. IgA nephropa­thy can devel­op in any­one, but is more com­mon in males and in Asian or Cau­casian indi­vid­u­als. Peo­ple with liv­er dis­ease, celi­ac dis­ease and some chron­ic ill­ness­es like HIV and oth­er bac­te­r­i­al infec­tions may also have a high­er risk.

Often in its ear­ly stages, IgA nephropa­thy does­n’t have any tell-tale warn­ing signs or symp­toms, allow­ing the dis­ease to go unno­ticed for years. The most com­mon symp­tom report­ed is changes in the appear­ance of urine. IgA nephropa­thy caus­es an increase of blood and pro­tein in the urine. Vis­i­ble blood may be seen or small­er, micro­scop­ic amounts of blood may cause the urine to be a dark­er, tea- col­or. Increased pro­tein in the urine can cause a cloudi­er, bub­bly or foamy appear­ance. As the dis­ease pro­gress­es and kid­ney dam­age wors­ens, addi­tion­al symp­toms may include:

• Pain along the side of your back below your ribs
• Swelling in the hands and feet
• Ele­vat­ed blood pressure

It is impor­tant to note that IgA nephropa­thy is not the only rea­son blood or pro­tein may appear in urine. It may also be due to increased inten­si­ty of exer­cise, cer­tain foods or med­ica­tions, a uri­nary tract infec­tion and oth­er med­ical con­di­tions. If you notice blood or notice a dis­col­oration in your urine your physi­cian can help you deter­mine the cause. While rou­tine tests can con­firm the pres­ence of pro­tein or blood in the urine, in order to con­firm an IgA nephropa­thy diag­no­sis, your doc­tor will need to per­form a kid­ney biopsy.

IgA neu­ropa­thy impacts each indi­vid­ual dif­fer­ent­ly. Some patients may notice lit­tle impact on their life, and be able to main­tain their kid­ney func­tion for years while oth­ers may devel­op addi­tion­al side effects or increas­ing­ly wors­en­ing kid­ney dam­age that could progress into kid­ney fail­ure and require a trans­plant. Some addi­tion­al com­pli­ca­tions of IgA neu­ropa­thy can include: 

• High blood pressure
• High Cho­les­terol
• Kid­ney failure
• Chron­ic kid­ney disease

There is no cure for IgA neu­ropa­thy but med­ica­tions may help slow the pro­gres­sion of the dis­ease and help man­age some of the side effects. In order to min­i­mize your risk of fur­ther kid­ney dam­age and main­tain your kid­ney func­tion, your doc­tor will focus on con­trol­ling your blood pres­sure and cho­les­terol lev­el and to reduce the pro­tein in your urine. ACE inhibitor and ARB med­ica­tions may be pre­scribed along with dietary changes (pri­mar­i­ly salt and pro­tein reduc­tion) to keep these lev­els with­in the desired range. A In some cas­es fish oil sup­ple­ments or immuno­sup­pres­sant med­ica­tions such as steroids may be recommended.

This dis­ease affects every­one dif­fer­ent­ly so it is impor­tant that you work with your physi­cian to close­ly mon­i­tor your symp­toms and over­all well­ness, deter­mine the best treat­ment plan and make any changes when necessary.

To speak to a DMG nephrol­o­gist about any kid­ney con­cerns, please call 630−873−8889.