Immunoglobulin A (IgA) nephropathy is a condition that causes a certain type of protein to build up in your kidneys. It progresses differently in everyone. Your kidneys might still work well years later. Or you could quickly develop end-stage renal disease (ESRD), also known as end-stage kidney disease or kidney failure. This means your kidneys can no longer filter waste.
The good news is that there are ways to slow the damage. Ask your nephrologist (kidney doctor) which medications might work for you and if there are other ways you can protect your kidneys.
How Does IgA Nephropathy Damage Your Kidneys?
IgA is a protein your immune system makes. It attaches to germs and signals your immune system to protect your body from infection. But when you have IgA nephropathy, this protein doesn't work like it should. Instead of sticking to germs, it clumps together in your kidneys. This signals your immune system like usual, triggering inflammation.
The buildup of IgA in your kidneys slowly damages tiny filters called glomeruli that clean your blood. Some people live with IgA nephropathy for 10 or more years without symptoms. But eventually, damage from IgA nephropathy can badly scar your kidneys and lead to other issues.
What Are the Symptoms of IgA Nephropathy?
Bloody urine. This is called hematuria. It’s one of the most common and earliest symptoms of IgA nephropathy. It’s a sign that your glomeruli are damaged and leaking blood into your urine. You may notice a reddish, pink, or brown color when you pee. Sometimes the color looks
like tea or cola. The blood might appear shortly after you've been sick with a cold or other respiratory infection, or when you exercise. Sometimes the amount of blood is too small to see with your naked eye. It might only be visible under a microscope when the doctor tests your urine.
Protein in your urine. Damaged kidneys leak a protein called albumin into your urine. Foamy urine is a sign of this. Some people with IgA nephropathy take regular steroids, budesonide (Tarpeyo), or SGLT-2 inhibitors to lower the amount of protein in their urine.
Swollen legs and feet. With kidney disease, you may not be able to get rid of fluid normally. That extra fluid collects and causes swelling, also known as edema. You may notice swelling in your legs, feet, and ankles. Your face or hands might swell, too.
High blood pressure. Your kidneys do more than filter your blood. They also help control blood pressure. That’s the force of blood against artery walls as your heart pumps it through the body. Kidney disease can cause high blood pressure, which in turn can also worsen kidney disease. In time, the cycle of kidney damage and high blood pressure can lead to kidney failure. In fact, high blood pressure is one of the leading causes of kidney failure.
What Are the Complications of IgA Nephropathy?
Nephrotic syndrome. This can happen when your glomeruli are damaged. It includes:
- Too much protein in your urine
- Too little protein in your blood
- High levels of cholesterol and fats called lipids in your blood
- Swelling in places like your eyelids, feet, and belly
Chronic kidney disease (CKD). After you've lived with IgA nephropathy for a while, your kidneys may be too damaged to filter wastes and fluid out of your blood. Kidney disease has five stages:
Stage 1: Your kidneys still work at 90 to 100 percent, but you have signs of damage, like protein or blood in your urine.
Stage 2: Your kidneys are working at 60 to 89 percent and have some damage.
Stage 3: Your kidneys are working at 30 to 59 percent.
Stage 4: Your kidneys have become severely damaged and are only working at 15 to 29 percent.
Stage 5: Your kidneys are working at less than 15 percent.
ESRD: Your kidneys have failed and you need dialysis or a kidney transplant.
You can't reverse kidney damage, but you can slow it with medications and other treatments.
End-Stage Renal Disease (ESRD)
In some people, kidney damage slowly gets worse. Your doctor can keep track of how well your kidneys work with a test called glomerular filtration rate (eGFR). It measures how much blood your kidneys filter in a minute. A low number is a sign of kidney damage.
Once you're in kidney failure, you have two options. You can get dialysis, a treatment that removes wastes and extra fluid from your blood like healthy kidneys would. Or you can get a kidney transplant from a donor. A kidney transplant is a longer-term solution, but if you don’t know someone who is willing to give you a kidney then the average wait time for a deceased donor kidney is 3 to 5 years.
How to Protect Your Kidneys
There's no way to cure IgA nephropathy or stop it from happening, but there are a few things you can do to protect your kidneys. If you have a family history of the condition, ask your doctor how to keep your blood pressure and cholesterol at healthy levels.
Once you've been diagnosed with IgA nephropathy, you can take medications to:
- Control your blood pressure
- Lower cholesterol
- Remove extra fluid from your blood
- And in some case, suppress the immune system and control inflammation
Other ways to keep your blood pressure in check include limiting salt in your diet and living a healthy lifestyle with exercise and keeping your weight in check. Cut back on foods high in saturated fat, like meat and butter, to control lipid levels in your blood.
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American Heart Association: "How High Blood Pressure Can Lead to Kidney Damage or Failure."
American Kidney Fund: "Chronic Kidney Disease," "IgA Nephropathy."
CDC: "High Blood Pressure Symptoms and Causes."
Mayo Clinic: "IgA nephropathy (Berger's disease)."
Mount Sinai: "Albumin - blood (serum) test."
National Institute of Diabetes and Digestive and Kidney Diseases: "High Blood Pressure & Kidney Disease," "IgA Nephropathy."
National Kidney Foundation: "Choosing a Treatment for Kidney Failure," "Dialysis," "IgA Nephropathy," "The Kidney Transplant Waitlist — What You Need to Know."
National Organization for Rare Disorders: "IgA Nephropathy."
UNC Kidney Center: "IgA Nephropathy."