IgA nephropathy is a kidney disease. This condition prevents the kidneys from filtering waste. Deposits of the protein immunoglobin A (IgA) build up inside the filters (glomeruli) within the kidneys. When this happens, the glomeruli can’t filter waste and excess water from the blood.

This is a potentially serious condition that requires care from your doctor. The sooner IgA nephropathy is treated, the more favorable the outcome.

Twenty-five percent of people with IgA nephropathy develop end-stage renal disease. End-stage renal disease or kidney failure is a serious condition. It occurs when the kidneys are not able to perform their normal functions. If you suspect you have IgA nephropathy, contact your doctor immediately.

Causes

It is not known what causes IgA nephropathy. Genetics may play a role. It appears that some people are predisposed to this condition.

Risk Factors

The following factors increase your chances of developing IgA nephropathy:

• Family history of IgA nephropathy or Henoch Schonelein purpura; Henoch Schonelein purpura is an inflammation of the blood vessels in the skin and other body organs.

• Sex: Men tend to develop this condition more often than women.

• Age: IgA nephropathy usually develops between the late teenage years to the late 30s.

• High blood pressure

• High cholesterol

Symptoms

Often, there are no symptoms of IgA nephropathy in the early stages of the disease. Later stage symptoms may include:

• Blood and protein in the urine

• Swelling in hands and feet

• Repeated upper respiratory infections

• Intestinal disease

• High blood pressure

• High cholesterol

• Feeling tired

• Muscle pain

• Fever

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following:

• Urinalysis: Your doctor will test a sample of urine for blood, protein, and fat.

• Blood test

• Kidney biopsy: A sample of tissue or cells from the kidney are removed for examination.

• Blood pressure measurement

• Cholesterol test

Treatment

There is no cure for IgA nephropathy. Your doctor will want to help prevent the condition from getting worse and relieve symptoms, such as high blood pressure. Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

Your doctor may suggest the following medications:

• Angiotensin-converting Enzyme Inhibitors (ACE inhibitors) to help lower blood pressure and decrease protein loss in the urine.

• Corticosteroids (kor-ti-koe-STER-oyds) (cortisone-like medicines) to provide relief for inflamed areas of the body.

Dietary Changes

Your doctor may want you to reduce salt and limit the amount of protein in your diet. You can limit protein in your diet by avoiding most meats, dairy products, and gluten. Gluten is a protein that is found in wheat, rye, barley, and oats.

Control Cholesterol

If you have high cholesterol, your doctor will want you to lower your cholesterol level. You can do this by making changes to your diet and exercising. Your doctor may also prescribe cholesterol-lowering medicine.

Fish Oil

Some studies have shown that taking fish oil supplements may help slow IgA nephropathy.

Tonsillectomy

Some studies have shown that surgically removing the tonsils in people who have IgA nephropathy and have frequent infections in their tonsils may reduce the amount of blood and protein in their urine.

Dialysis

People who develop kidney failure as a result of IgA nephropathy may need to have dialysis. Dialysis is a treatment that performs the functions of natural kidneys when they fail.

Kidney Transplant

People who develop kidney failure as a result of IgA nephropathy may need to have a kidney transplant. During a kidney transplant, a severely diseased and damaged kidney is replaced with a healthy kidney from a donor.

Prevention

To help reduce your chances of getting IgA nephropathy, take the following steps:

• Manage your blood pressure and cholesterol levels:

• • Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.

• • Exercise regularly.

• • Maintain a healthy weight.

• • Don't smoke. If you smoke, quit.

• • Drink alcohol in moderation. Moderate alcohol intake is no more than two drinks per day for men and one drink per day for women.

• • Lose weight if necessary. Your doctor can recommend a safe weight loss plan and a reasonable target weight.

• • Consider counseling, stress reduction exercises, and meditation to decrease the stress in your life.

• • Take medicine. Your doctor may prescribe medicine to help lower your blood pressure and/or cholesterol levels.

• Tell your doctor if you have a family history of IgA nephropathy or other forms of kidney disease. This way, your doctor can be on the lookout for signs of IgA nephropathy.

RESOURCES:

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

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

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

CANADIAN RESOURCES:

BC Health Guide, British Columbia Ministry of Health
http://www.bchealthguide.org

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

References:

Are you at increased risk for chronic kidney disease (CKD)? National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozItem.cfm?id=134. Accessed September 14, 2005.

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

Corticosteroids—glucocorticoid effects (systemic). EBSCO Publishing Health Library website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942D&chunkiid=26508. Accessed September 20, 2005.

Donadio J, Grande J. IgA Nephropathy. N Engl J Med. 2002; 347(10):738-748.

Henoch-Schonlein purpura (Condition in Brief). EBSCO Publishing Health Library website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942D&chunkiid=22827. Accessed September 20, 2005.

IgA nephropathy. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase. Accessed September 13, 2005.

IgA nephropathy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozItem.cfm?id=76. Accessed September 20, 2005.

IgA nephropathy. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/iganephropathy/. Accessed September 12, 2005.

IgA nephropathy (Berger’s disease). MedlinePlus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000466.htm. Accessed September 12, 2005.

Immunoglobin A (IgA) nephropathy. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/uvahealth/adult_urology/iganeph.cfm. Accessed September 14, 2005.

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