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IgA Nephropathy
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IgA Nephropathy

(Immunoglobulin A Nephropathy; Berger’s Disease)

Pronounced: ne-frop-a-thee

En Español (Spanish Version)

Definition

IgA nephropathy is a kidney disease. This condition prevents the kidneys from filtering waste. Deposits of the protein immunoglobulin 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.

Anatomy of the Kidney

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© 2008 Nucleus Medical Art, Inc.

Causes

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

Risk Factors

The following factors increase your chance of developing IgA nephropathy:

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 of the hands and feet
  • Repeated upper respiratory infections
  • Intestinal disease
  • High blood pressure
  • High cholesterol
  • Fatigue
  • 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—to test for blood and protein
  • Blood test
  • Kidney biopsy—removal of a sample of tissue or cells from the kidney 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—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

Small studies suggest that fish may be helpful in 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 watch for signs of IgA nephropathy.

RESOURCES:

American Kidney Fund
http://www.kidneyfund.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
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 January 13, 2008.

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

Corticosteroids—glucocorticoid effects (systemic). EBSCO Health Library website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942Dchunkiid=26508 . Accessed September 20, 2005.

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

Fish oil. EBSCO Health Library, Natural and Alternative Treatments website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?token=da29d243-e573-4601-8b42-77cd0ccb14b2chunkiid=21684 . Accessed February 5, 2008.

Henoch-Schonlein purpura (Condition in Brief). EBSCO Health Library website. Available at: http://healthlibrary.epnet.com/GetContent.aspx?token=D39207C8-9100-4DC0-9027-9AC6BA11942Dchunkiid=22827 . Accessed September 20, 2005.

IgA nephropathy. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Accessed January 13, 2008.

IgA nephropathy. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/atozItem.cfm?id=76 . Accessed January 13, 2008.

IgA nephropathy. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/iganephropathy/ . Accessed January 13, 2008.

IgA nephropathy (Berger’s disease). National Library of Medicine, MedlinePlus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000466.htm . Accessed January 13, 2008.

Immunoglobin A (IgA) nephropathy. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/uvahealth/adult_urology/iganeph.cfm . Accessed January 13, 2008.

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



Last reviewed January 2008 by Adrienne Carmack, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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