What is IgA Nephropathy?
IgA Nephropathy, also known as Berger’s Disease, is an autoimmune renal disease that affects the filters (glomeruli) of the kidneys in patients. IgA is an immunoglobulin, which is a part of a patient’s healthy immune system. This kidney disease typically occurs when the antibody IgA immunoglobulin builds up to an abnormal amount in the kidneys. The IgA immunoglobulin normally attaches itself to an infection found in the body, triggering an immune response and works to eliminate the infection. When an individual has IgA nephropathy, a defective form of IgA attaches itself to another IgA molecule instead of an infection, causing a renal immune complex. These then become stuck in the kidney’s glomeruli, which causes inflammation and damages the kidney’s filters. Eventually, this disease can cause blood and proteins to leak out of the kidneys and into the urine, resulting in Proteinuria.
How is IgA Nephropathy Diagnosed?
A Proteinuria level of blood or protein in the urine found through a routine urinalysis is usually the first step in diagnosing IgA Nephropathy. A blood test for serum creatinine can be used to calculate glomerular filtration rate (GFR), which reads how well a patient’s kidneys are filtering wastes from the blood. However, these tests alone are not sufficient to diagnose a patient with IgA Nephropathy. For a normal diagnosis of a kidney disease, it is necessary to do a kidney biopsy.
What are the Symptoms of IgA Nephropathy?
IgA nephropathy usually doesn’t cause symptoms in the early stages. It is first suspected when routine urinalysis tests reveal protein and red blood cells in a patient’s urine that can’t be seen with the naked eye. As IgA Nephropathy develops, symptoms of renal disease can begin to appear.
Symptoms of IgA nephropathy when kidney function is impaired include:
- Dark (cola or tea colored) urine caused by Hematuria
- Repeated instances of dark colored urine, usually after intense exercise or an infection. In some cases, blood can actually be seen in patient’s urine.
- Proteinuria – Large amounts of protein “spilling” into the urine
- Edema – Swelling in parts of the body, most noticeable around the eyes, hands and feet, and abdomen.
- Low Blood Albumin Levels
- Foam in urine
- High Cholesterol in some cases
- High Blood Pressure in some cases
In some cases, a patient may be the first to notice signs or symptoms of IgA Nephropathy. If the disease has progressed far enough, a patient might notice blood in their own urine or swelling of the hands and feet. If these symptoms are recurring, a patient should contact a doctor or clinic for further tests.
Who gets IgA Nephropathy?
Scientists have not found the cause of the defective IgA immunoglobulin in patients who suffer from IgA Nephropathy. It is likely to have both genetic and environmental components. IgA occurs mostly in Caucasian and Asians. It is uncommon in those of African decent. IgA is twice as common in males and although it can affect any age group, it is usually diagnosed in early and middle aged adults. In some cases, renal diseases have been found to run in families, indicating the heavy possibility of a genetic component.
How is IgA Nephropathy Treated?
There’s no known cure for IgA nephropathy and no definitive way of knowing what direction the disease will take. Some people experience complete remission, others live normal lives with low amounts blood or protein in their urine, while some patients progress to renal failure.
Some patients do not require active treatment, but only require clinical monitoring to insure the disease doesn’t progress into major renal issues. Other patients need an active treatment path with medication therapy can slow the progress of the disease and help manage symptoms such as high blood pressure, protein in the urine, and swelling.
It is important to see a kidney specialist on a regular basis to monitor kidney function, degree of proteinuria, cholesterol and blood pressure. Many different types of immunosuppressants, or drugs that suppress the immune system, including steroids, can also be considered.
If remission is not obtained, it is important for patients to remain on medication treatments that reduces the amount of protein in the urine. These medications are called ACE-inhibitors (angiotensin converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers).
Your nephrologist may also recommend:
- Diuretics to help eliminate excess fluids in the body
- A low sodium diet help to control edema
- Anticoagulants can help to prevent blood clots
- Immunosuppressive treatments can help prevent the body’s immune system reaction. This can lower the body’s attack on the glomeruli.
- Blood Pressure medications, such as ACE inhibitors or angiotensin receptor blockers (ARBs), to lower high blood pressure
- Statin therapy to help lower the cholesterol level
- Maintaining a healthy diet: Correct amounts of protein and fluid intake according to your nephrologist’s recommendations. A healthy diet consists of low salt with emphasis on fruits and vegetables, low in saturated fat and cholesterol.
- Omega-3 fatty acids, often found in fish oil supplements or vitamins, can aid in reducing renal inflammation without some of the side effects of traditional drug therapies. Check with a doctor, and never stop taking other anti-inflammatories without a doctor’s permission.
- Not smoking
Since there is no true cure for IgA Nephropathy, these treatments and therapy options are all aimed at reducing the symptoms of renal disease and to avoid the progression of the disease to the point of kidney failure or the need of a kidney transplant.
Click here for specific information about each treatment option.
The ultimate goal with treatment is to avoid progression into end stage renal disease, the need for dialysis or kidney transplantation.