IgA Nephropathy
Immunoglobulin A (IgA) nephropathy generally takes a long time to develop, progressing in 10 to 20 years and leading to end-stage renal failure.

Immunoglobulin A (IgA) nephropathy is a chronic kidney disease caused by IgA protein deposits inside the kidney's filters (glomeruli). Usually, these glomeruli filter waste and surplus water from the circulation, delivering it to the bladder in the form of urine. The IgA protein, however, hinders this filtration, which may cause hematuria and proteinuria (presence of blood and proteins in the urine).

IgA nephropathy generally takes a long time to develop, progressing in 10 to 20 years and leading to end-stage renal failure. Some patients with normal renal function and minor protein in the urine can be followed up conservatively without any treatment. Because of the disease's gradual course, doctors have had a tough time deciding on the ideal treatment.

There is no cure for IgA nephropathy. Therefore, it cannot be predicted how each person will be affected. The disease progresses slowly in most people, with up to 70 percent of patients expected to live a normal lifespan without any difficulties.

What causes IgA nephropathy?

The immunoglobulin A (IgA) protein is a healthy component of the immune system. The causes of IgA deposits in the glomeruli are unknown.

  • It is inherited more than 10 percent of the time.
  • Some people who inherit the gene may not show any symptoms, but they may be able to pass it on to their children.
  • Men are more likely to be affected than women.

IgA nephropathy is seen more frequently in Caucasians and Asians and is more common in adults aged 20 to 40 years old.

What are some of the signs and symptoms of IgA nephropathy?

Immunoglobulin A (IgA) nephropathy is a condition that often goes unnoticed for years. The onset can happen at any age, but symptoms usually appear before the age of 40 years. 

Blood in the urine is the most common sign (hematuria). It takes a long time for it to reach the point where it causes complications, such as swelling over the body and electrolyte imbalances.

Flank pain and a mild fever are common symptoms of IgA nephropathy. Blood pressure can become dangerously high in very uncommon circumstances.

How is IgA nephropathy diagnosed?

A physical exam and a review of the patient’s medical history will be conducted by the healthcare practitioner.

Other tests that may be performed include:

  • Blood pressure checks
  • Cholesterol tests
  • Protein in urine tests
  • Protein in blood tests
  • Kidney biopsy to identify immunoglobulin A (IgA) deposits
    • A sample of kidney tissue is taken and analyzed under a microscope for this test.

QUESTION

The only purpose of the kidneys is to filter blood. See Answer

How is IgA nephropathy treated?

The treatment people receive will be determined by their symptoms, severity of the disease, age, and overall health. 

Medicines may be used as part of the treatment, such as:

  • Angiotensin-converting enzyme (ACE) inhibitors: Blood pressure medications, especially ACE inhibitors, help lower blood pressure and protect the kidneys. They help keep protein from leaking into the urine.
  • Corticosteroids: These drugs help minimize renal inflammation and scar formation, however, they should not be taken by pregnant women.
  • Fish oil with a prescription-strength: This helps reduce renal inflammation and damage. Although, more research is needed to prove its efficacy.
  • Statins: People who have kidney disease are more likely to have a stroke or a heart attack. Cholesterol control can help lower the risk of both. Statins help manage the cholesterol levels in the blood.

Lifestyle modifications

  • Dietary interventions: These interventions include
    • keeping a check on dietary protein consumption (1.32 mg/lb of body weight a day), including complex carbs in the diet,
    • having a high-fiber diet to keep sugars and lipids in check, and
    • avoiding foods rich in uric acid and potassium that help prevent additional kidney injury.
  • Quitting smoking and alcohol
  • If necessary, exercise and weight loss
  • Adequate hydration

What are the complications associated with IgA nephropathy?

Possible complications associated with immunoglobulin A (IgA) nephropathy include:

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Medically Reviewed on 11/4/2021
References
Image Source: iStock Images

Salim SA. IgA Nephropathy. Medscape. https://emedicine.medscape.com/article/239927-overview

Rodrigues JC, Haas M, Reich HN. IgA Nephropathy. CJASN. April 2017; 12(4): 677-686. https://cjasn.asnjournals.org/content/12/4/677

UNC Kidney Center. IgA Nephropathy. https://unckidneycenter.org/kidneyhealthlibrary/glomerular-disease/iga-nephropathy/