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IgA nephropathy is progressive. That means it gets worse the longer you have it. It's not curable, but treatments can slow kidney damage and keep these organs working longer. It's important to know what to expect when you have a progressive condition like IgA nephropathy. Learn the signs of kidney failure and know your options if your kidneys do stop working.

How Does IgA Nephropathy Progress?

IgA nephropathy has a different timeline in each person. Some people have no symptoms. They may not even know they have the disease. Others have symptoms like blood in their urine, but their kidneys keep working fine. Some people go into end-stage renal disease (ESRD) or kidney failure within a few months or over many years. Taking medication may put IgA nephropathy into remission. That’s when you no longer have any signs or symptoms of the disease.

Kidney damage leads to kidney failure within 10 to 20 years in about 1 out of every 4 people with IgA nephropathy. Everyone else either goes into remission or continues to have protein and/or blood in their urine, but no serious kidney damage.

How Does End-Stage Kidney Failure Happen?

Over time, the inflammation can scar your kidneys and let blood and protein leak into your pee. If the scarring gets bad enough, you may develop end-stage renal disease. This is the last stage of kidney disease when your kidneys can no longer filter waste from your blood. You’ll need dialysis or a kidney transplant to do the work for your damaged kidneys.

What Makes IgA Nephropathy Progress Faster?

IgA nephropathy may progress more quickly if you have:

  • Large amounts of protein or blood in your pee
  • High blood pressure that isn't under good control
  • Worsened kidney function already, as determined by blood tests that measure creatinine and estimated glomerular filtration rate (eGFR)
  • Scarring in your kidneys' filters, called glomerulosclerosis, which can be measured on a kidney biopsy

Your doctor can predict how likely your IgA nephropathy is to get worse within the next 5 years using a test called the International IgA Nephropathy Prediction Tool. Other things that make IgA nephropathy progress faster are under your control. You can take steps to:

  • Lose weight if you’re very overweight
  • Eat fewer saturated fats like butter and oils if you have high triglycerides
  • Stop smoking
  • Watch your salt intake

What Are the Symptoms of Kidney Failure?

End-stage kidney failure, or ESRD, is the last stage of kidney damage. At this point, your kidneys don't work well enough to keep your body healthy. 

These are a few signs that your kidneys are no longer working, and it may be time for dialysis or a kidney transplant:

  • Tiredness and weakness
  • Nausea and vomiting
  • Little to no urine when you pee
  • Itching
  • Weight loss
  • Headache
  • Poor appetite
  • Metallic taste

You might also have shortness of breath or chest pain if extra fluid collects in your lungs. Swelling in your feet or ankles is a sign of fluid buildup, too.

Your doctor can check for ESRD with blood tests, urine tests, and imaging tests like ultrasound and CT scans. A biopsy checks a small piece your doctor removes from your kidney under the microscope for damage.

When Would You Need Dialysis for IgA Nephropathy?

Kidney failure means you've lost more than 85 to 90 percent of your kidney function. Your kidneys won't get better at this point, so you'll need either dialysis or a kidney transplant to remove wastes and fluid. 

Dialysis is a treatment that filters wastes and fluids from your blood and helps to control your blood pressure. It comes in two types:

Hemodialysis uses a machine to filter your blood. The machine cleans waste from your blood and then returns the filtered blood to your body. You can have this treatment at a hospital or a dialysis center, or you can do it yourself at home a few times a week. The process takes 3 to 5 hours.

Peritoneal dialysis filters blood inside the lining of your belly using a special cleansing solution. You do this treatment at home following instructions from your doctor.

Kidney Transplant for IgA Nephropathy 

A kidney transplant is a more long-term treatment for kidney failure. It can give you the freedom of not having to do dialysis several times a week. Studies show that people who get a kidney transplant live longer than those who use dialysis. But a transplant involves surgery and you’ll need a donor.

The donor kidney can come from someone who has died, called a deceased donor. Or it can come from a living donor who is willing to give up one of their two kidneys.

There are risks to having a kidney transplant. You will have to take medication for the rest of your life to keep your body from rejecting the organ. And the transplant may not be permanent. Some people need a second transplant in the future if their donated kidney stops working.

If you do get to kidney failure, talk with your doctor about your options. Make sure you understand the pros and cons of dialysis and a kidney transplant before making your decision.

Show Sources

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Cell Biochemistry and Biophysics: "IgA nephropathy factors that predict and accelerate progression to end-stage renal disease."

Cleveland Clinic: "Dialysis," "End-Stage Renal (Kidney) Disease," "IgA Nephropathy."

Johns Hopkins Medicine: "End Stage Renal Disease (ESRD)."

Mayo Clinic: "End-stage renal disease," "IgA nephropathy (Berger's disease)."

National Institute of Diabetes and Digestive and Kidney Diseases: "Explaining Your Kidney Test Results: A Tool for Clinical Use."

National Kidney Foundation: "Dialysis," "Kidney Transplant."

PLoS One: "Predicting Progression of IgA Nephropathy: New Clinical Progression Risk Score."

UpToDate: "IgA nephropathy: Treatment and prognosis."