What is IgA nephropathy?
IgA nephropathy is a kidney disorder that occurs
when IgA-a protein that helps the body fight
infections-settles in the kidneys. After many
years, the IgA deposits may cause the kidneys to
leak blood and sometimes protein in the urine.
Many people with IgA nephropathy leak blood in
the urine, but this leakage does not mean they
will have long-term problems. Others leak both
blood and protein in the urine. If too much
protein leaks into the urine, the hands and feet
can swell. After 10 to 20 years with IgA
nephropathy, the kidneys may show signs of
damage. About 25 percent of adults with IgA
nephropathy develop total kidney failure. Only 5
to 10 percent of children develop total kidney
failure. Symptoms of kidney failure include
swelling in the hands and feet, nausea, fatigue,
headaches, and sleep problems. By the time these
symptoms occur, total kidney failure is near.
Total kidney failure means the kidney damage is
permanent. People with kidney failure need
dialysis or a kidney transplant.
How do people know that they have IgA
In the early stages, IgA nephropathy has no
symptoms. This disease can be silent for years,
even decades. The first sign of IgA nephropathy
may be blood in the urine. The blood may appear
during a cold, sore throat, or other infection.
At times, blood in the urine can only be
detected by a doctor or nurse using special
tests. If the amount of blood increases, urine
may turn pink or the color of tea or cola.
People who have blood in their urine should see
a doctor or nurse, but the condition is not
always a sign of a serious disease. For example,
heavy exercise can cause blood in the urine.
Who is at risk for IgA nephropathy?
IgA nephropathy can occur at any age, even in
childhood. More men are affected than women.
Although found all over the world, IgA
nephropathy is more common among Caucasians and
Asians. It is one of the most common diseases of
the kidney, other than those caused by diabetes
or high blood pressure.
What causes IgA nephropathy?
Scientists do not know what causes IgA deposits
to form in the kidneys. IgA nephropathy may run
in families or be related to respiratory
infections. No consistent trigger for the
disease has been found.
How is IgA nephropathy diagnosed?
A urine test called urinalysis usually provides
the first clues. In a urinalysis, the doctor or
nurse dips a special strip with chemicals into
the urine sample. The strip changes color when
blood or protein is present in the urine. If the
test strip is positive, the urine will then be
examined with a microscope to look for red blood
cells. The red blood cells may be clumped
together to form little tubes. These tubes are
called casts because they are formed or molded
inside the kidneys’ tiny draining structures. If
casts are found, it usually means the kidney
filters are damaged.
Blood tests measure the waste products in the
blood that the kidneys usually get rid of. Two
examples are creatinine and blood urea nitrogen
(BUN). If the BUN and creatinine levels are
high, it means the kidneys are not working well.
If the creatinine level is high at the time of
diagnosis, the patient is more likely to develop
If there is kidney damage, the doctor will
probably recommend a kidney biopsy. In this
procedure, a needle is used to retrieve a small
piece of kidney tissue for examination with
different microscopes. Only a biopsy can show
the IgA deposits in the kidney filters. The
biopsy can also tell how much kidney damage has
already occurred. The biopsy results can help
the doctor determine the best treatment. Once a
diagnosis of IgA nephropathy is established, a
person should have regular blood tests to
monitor kidney function.
How is IgA nephropathy treated?
Kidney disease usually cannot be cured. When the
kidneys are damaged, they cannot be repaired.
Treatment focuses on slowing the disease and
One complication is high blood pressure, also
called hypertension. Hypertension damages the
kidneys. Two types of blood pressure medicines
called angiotensin-converting enzyme (ACE)
inhibitors and angiotensin receptor blockers
(ARBs) protect kidney function. These medicines
not only lower blood pressure but also decrease
the loss of protein into the urine. Because of
this effect, they are often used in IgA
nephropathy to protect the kidneys. They are
good medicines but have certain side effects.
Pregnant women should not take ACE inhibitors or
ARBs because they can damage the unborn baby.
People with IgA nephropathy may develop high
cholesterol. By watching their diet and taking
medicine, they can help lower their cholesterol
level. Lowering cholesterol may help slow kidney
Medicines such as prednisone may help treat IgA
nephropathy. Prednisone belongs to a class of
medicines called corticosteroids, which can have
harmful side effects. In research studies, fish
oil supplements containing omega 3 fatty acids
also slowed kidney damage in some patients.
Vitamin E may help lower protein in the urine
but not blood. One of the newer
immunosuppressive agents called mycophenolate
mofetil (MMF) is also being tested in treating