Overview
IgA nephropathy, also known as Berger disease, is a kidney disease that occurs when a specific type of germ-fighting protein called immunoglobulin A (IgA) builds up in the kidneys. This leads to inflammation, which can make it harder for the kidneys to filter waste from the blood over time. The disease often develops slowly and can vary in its progression from person to person. Some people may experience few or no symptoms, while others may develop complications such as high blood pressure, high cholesterol, acute kidney failure, or even kidney failure. There is no cure for IgA nephropathy, but medications can help slow its progression and manage symptoms.
Understanding the disease
Symptoms
Symptoms of IgA nephropathy may include blood in the urine (hematuria), foamy urine from protein leaking into the urine (proteinuria), pain on one or both sides of the back below the ribs, swelling in the hands and feet (edema), high blood pressure, weakness and tiredness. If the disease leads to kidney failure, symptoms may include rashes and itchy skin, muscle cramps, upset stomach and vomiting, less appetite, metallic taste in the mouth, confusion. IgA nephropathy often doesn't cause symptoms early on, but if it progresses, it can lead to complications such as high blood pressure, high cholesterol, acute kidney failure, chronic kidney disease, and nephrotic syndrome. There's no cure for IgA nephropathy, but medicines can slow how quickly it becomes worse. It's important to see a doctor if you notice blood in your urine or sudden swelling in your hands or feet.
Risk Factors
The risk factors for developing IgA nephropathy include:
- Sex: In North America and Western Europe, IgA nephropathy affects at least twice as many men as it does women.
- Ethnicity: IgA nephropathy is more common in white people and people of Asian descent than it is in Black people.
- Age: IgA nephropathy most often develops between the mid-teens and mid-30s.
- Family history: IgA nephropathy appears to run in some families.
- Chronic kidney disease: IgA nephropathy can cause the kidneys to stop working over time, leading to the need for dialysis or a kidney transplant.
- Nephrotic syndrome: This is a group of problems that can be caused by damage to the glomeruli. The problems can include high urine protein levels, low blood protein levels, high cholesterol, and lipids, and swelling of the eyelids, feet, and stomach area. It is important to note that the exact cause of IgA nephropathy is unknown, and these risk factors may not apply to everyone with the condition.
Development
IgA nephropathy is a kidney disease where the germ-fighting protein called immunoglobulin A (IgA) builds up in the kidneys, causing inflammation that can impair the kidneys' ability to filter waste from the blood. The course of the disease varies from person to person, and some people may experience complications such as high blood pressure, high cholesterol, acute kidney failure, chronic kidney disease, or nephrotic syndrome. The disease most commonly develops between the mid-teens and mid-30s, and it appears to run in some families. While the exact cause of IgA nephropathy is unknown, certain risk factors include sex, ethnicity, age, and family history. It is more common in people of Asian and European descent, and affects at least twice as many men as women in North America and Western Europe.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect IgA nephropathy if you notice blood in your urine that doesn't go away or keeps happening, or if you experience sudden swelling in your hands or feet. It's important to get a checkup if you have any signs of the disease, as IgA nephropathy can lead to complications such as high blood pressure, high cholesterol, acute kidney failure, chronic kidney disease, and nephrotic syndrome. Early diagnosis and treatment can help manage the disease and prevent further kidney damage.
Diagnosis
To diagnose IgA nephropathy, several tests are typically performed, including:
- Urine tests: A laboratory checks a sample of your urine under a microscope to assess kidney function and detect blood or protein in the urine. IgA nephropathy can indicate inflammation of the glomeruli in the kidneys.
- Blood tests: These tests can reveal higher levels of creatinine or cystatin C, which are waste products typically filtered by healthy kidneys.
- Kidney biopsy: A special needle is used to remove small pieces of kidney tissue for examination under a microscope. This is the most reliable method to confirm IgA nephropathy.
- Iothalamate clearance test: This test uses a contrast agent to evaluate how effectively your kidneys filter waste. IgA nephropathy is diagnosed based on the presence of blood in the urine, signs of glomerular inflammation, and the results of these tests.
Management and Treatment
Complications
Potential complications of IgA nephropathy include high blood pressure, high cholesterol, acute kidney failure, chronic kidney disease, nephrotic syndrome, and kidney failure. IgA buildup can damage kidney function, leading to these complications. Early diagnosis and management of high blood pressure and cholesterol can help slow the progression of the disease and prevent further complications.
Prevention
It is mentioned that IgA nephropathy cannot be prevented, and the article suggests discussing potential preventive measures with a doctor if there is a family history of the disease.
Home Remedies
It is important to consult with a healthcare professional for proper diagnosis and treatment of IgA nephropathy.
Treatment
Treatments for IgA nephropathy aim to slow its progression and manage related symptoms. There is no cure for the disease, but medications can help control inflammation, reduce proteinuria (excess protein in the urine), and prevent kidney failure. Some of the treatments that may be recommended include:
- Medications: Doctors may prescribe medications such as corticosteroids, immunosuppressants, or ACE inhibitors to help control inflammation, reduce proteinuria, and lower blood pressure.
- Blood pressure management: Controlling high blood pressure is crucial in managing IgA nephropathy. Following a healthy lifestyle, maintaining a balanced diet, and taking medications as prescribed can help keep blood pressure under control.
- Cholesterol management: Lowering cholesterol levels can help reduce the risk of complications such as heart disease. A healthy diet, regular exercise, and medications if needed can help manage cholesterol levels.
- Kidney-friendly diet: Adopting a diet that is low in salt, potassium, and phosphorus can help support kidney health. Consult a dietitian or healthcare provider for personalized dietary recommendations.
- Monitoring: Regular check-ups and monitoring with a nephrologist (kidney specialist) are essential to track the progression of the disease and adjust treatments accordingly. It's important to note that the treatments for IgA nephropathy may vary from person to person, based on the severity of the disease, the presence of complications, and the individual's overall health. Always consult with a healthcare professional for personalized advice and management strategies.
Preparing for medical consultation
To prepare for an appointment for IgA nephropathy, you should:
- Ask your doctor's office about any pre-appointment restrictions, such as fasting for a blood test or following specific dietary guidelines.
- Make a list of your symptoms, including when they began and any related or unrelated symptoms you are experiencing.
- Write down key personal information, including any recent changes or stressors in your life.
- Create a list of all medications, vitamins, or supplements you are currently taking.
- Consider bringing a family member or friend to the appointment for support and to help remember important details.
- Write down a list of questions to ask your healthcare provider during the appointment, such as:
- What is the most likely cause of my symptoms?
- What diagnostic tests do I need to confirm the diagnosis of IgA nephropathy?
- What is the best course of treatment for IgA nephropathy?
- Are there any lifestyle changes or dietary restrictions that I should follow?
- What is the outlook for patients with IgA nephropathy?
- Are there any clinical trials or new treatments available for this condition? Remember to be open and honest with your healthcare provider about your symptoms and concerns to ensure you receive the best possible care.