Description

IgA nephropathy (nuh-FROP-uh-thee), also known as Berger's disease, is a disease of the kidneys. This occurs when a germ-fighting protein called immunoglobulin a (IgA) builds up in the kidneys. This causes a type of swelling is called an inflammation that, over time, may make it more difficult for the kidneys to filter waste from the blood.

IgA nephropathy is often worse slowly over the years. But the course of the disease varies from person to person. Some people leak blood in their urine without having other problems. Others may have complications such as loss of renal function and spilling of protein in the urine. Other people develop kidney failure, which means that the kidneys stop working well enough to filter the body of the waste on their own.

There is No cure for IgA nephropathy, but medicines may slow down how quickly it becomes worse. Some people need treatment to lower inflammation, reduce the spilling of protein in the urine and prevent kidney failure. These treatments can help the disease to become not active, a state called remission. Keep your blood pressure under control and lowering cholesterol also to slow down the disease.

Symptoms

IgA nephropathy often does not cause symptoms early on. You may not be aware of any health effects for 10 years or more. Sometimes, the routine medical tests to find the signs of the disease, such as protein and red blood cells in the urine, which can be observed under a microscope.

When IgA nephropathy causes of the symptoms, which may include:

  • Coca - Cola-or tea-colored urine caused by blood. You might notice that these color changes after a cold, sore throat, or a respiratory infection.
  • In the blood, which can be seen in the urine.
  • Foamy urine protein leaking into the urine. This is called proteinuria.
  • Pain on one or both sides of the back below the ribs.
  • Swelling in the hands and feet is called edema.
  • The high blood pressure.
  • Weakness and tiredness.

If the disease leads to kidney failure, symptoms may include:

  • Rashes and itching on the skin.
  • Muscle cramps.
  • Upset stomach and vomiting.
  • Less of an appetite.
  • Metallic taste in the mouth.
  • Confusion.

Kidney failure is life-threatening without treatment. But dialysis or a kidney transplant may help people to live for many more years.

When to see a doctor

Consult your doctor if you think you have symptoms of IgA nephropathy. It is the key to getting a checkup if you notice blood in your urine. Several conditions can cause this symptom. But if it keeps happening or do not go away, it may be a sign of a serious health problem. Also consult with your doctor if you notice sudden swelling in your hands or feet.

Causes

The kidneys are two bean-shaped, fist-sized organs located in the lower part of the back, one on each side of the spine. Each kidney contains tiny blood vessels called glomeruli. These glasses filter waste, consumption of water and other substances from the blood. Then, the filtered blood goes back into the bloodstream. The waste products pass into the bladder and the body in the urine.

The immunoglobulin a (IgA) is a type of proteins called antibodies. The immune system produces antibodies to IgA to help attack the germs, and fight infections. But with IgA nephropathy, this protein accumulates in the glomeruli. This causes inflammation, and affects its ability to filter out over time.

The researchers do not know exactly what causes IgA to accumulate in the kidneys. But things could be linked with it:

  • Genes. IgA nephropathy is more common in some families and in certain ethnic groups, such as people of Asian and European descent.
  • Diseases of the liver. These include scarring of the liver called cirrhosis and chronic hepatitis B and C infections.
  • The celiac disease. Eating gluten, a protein found in most grains, triggers the digestive condition.
  • Infections. These include HIV and some bacterial infections.

Risk factors

The exact cause of IgA nephropathy is unknown. But these factors can increase the risk of disease:

  • Sex. In North America and Western Europe, IgA nephropathy affects at least two times as many men as well as women.
  • The ethnic origin. IgA nephropathy is more common in white people and people of Asian descent than in people of Black race.
  • Age. IgA nephropathy is most frequently develops between the mid-teens and mid-30s.
  • The history of the family. IgA nephropathy seems to run in some families.

Complications

The course of IgA nephropathy varies from person to person. Some people have the disease for years with few or no problem. Many of them are not diagnosed. Other people develop one or more of the following complications:

  • The high blood pressure. The damage to the kidneys of IgA accumulation can raise blood pressure. And high blood pressure can do more damage to the kidneys.
  • High cholesterol. High levels of cholesterol can increase the risk of a heart attack.
  • The acute renal failure. If the kidneys cannot filter your blood well enough due to the accumulation of IgA , the levels of waste products are rising rapidly in the blood. And if renal function worsens rapidly, health care professionals may use the term rapidly progressive glomerulonephritis.
  • Chronic kidney disease. IgA nephropathy can cause the kidneys to stop working over time. Then, a treatment called dialysis or a kidney transplant is needed to live.
  • The nephrotic syndrome. This is a group of problems that can be caused by damage to the glomeruli. The problems can include high protein in the urine, low levels of protein in the blood high levels of cholesterol and lipids, and the swelling of the eyelids, feet, and stomach area.

Prevention

You can not prevent IgA nephropathy. Talk with your doctor if you have a family history of the disease. Ask what you can do to keep your kidneys healthy. For example, it helps to lower your blood pressure and keep cholesterol at healthy levels.

Diagnosis

IgA nephropathy is often found after you notice blood in your urine. Or a routine test may show that it has protein or blood in the urine. You're going to need other tests also. They may include:

  • Urine tests. A laboratory can check a sample of your urine under a microscope. This is done to find out how well your kidneys are working and the amount of protein that the kidneys are affected. With IgA nephropathy, the laboratory test sample of blood in the urine, or other symptoms that could hint to the inflammation of the tiny filters in the kidneys, called glomeruli.
  • Blood tests. If you have kidney disease, blood tests may show higher levels of the waste product creatinine or protein of the cystatin C.
  • The renal biopsy. This procedure is the only way to confirm if you have IgA nephropathy. A special needle is used to take small pieces of kidney tissue. Then, the tissue is examined under a microscope.
  • Iothalamate clearance test. Your doctor also may recommend this test. It uses a contrast agent to track your kidneys are filtering the waste.

Treatment

There is No cure for IgA nephropathy. In addition there is no sure way to predict how the disease will affect your long-term health. Some people just need medical tests to know if the disease is getting worse.

For others, there are medications that can slow the disease from getting worse and help to control the symptoms.

Medications for the treatment of IgA nephropathy include:

  • High blood pressure medications. Medicines called angiotensin-converting enzyme inhibitors (acei) and angiotensin receptor antagonists (arbs) may lower blood pressure and reduce the amount of protein that the body loses.
  • The medications that calm the immune system. These are also called immunosuppressants. Include corticosteroids and other strong drugs that may decrease the body's defenses. You could keep the immune system from making the proteins that attack the glomeruli. These medicines can cause serious side effects, such as high blood pressure, high blood sugar and an increased risk of infection. Your doctor will help you choose an immunosuppressant medicine. Many of the new treatments have been approved or are currently being tested in clinical trials. Talk with your doctor about the latest advances in the treatment of IgA nephropathy.
  • Omega-3 fatty acids. These healthy fats may slow the inflammation of the glomeruli, without harmful side effects. You can get omega-3 from fish oil supplements. But do not buy off the shelf. Ask your doctor if the prescription fish oil supplements could help.
  • The cholesterol medicine. If you have high cholesterol, this type of medication can help to control and delay kidney damage.
  • Diuretics. These can help control the swelling in the hands and feet is called edema.

The main goal of treatment is to keep the need for dialysis or a kidney transplant. But any of these treatments can save your life if the kidneys stop working well enough on its own.

Lifestyle and home remedies

To help keep the kidneys healthy:

  • Take steps to reduce your blood pressure. This can help reduce the kidney damage in IgA nephropathy. Start with some lifestyle changes healthy. Limit the amount of sodium and fat that you eat. Lose any extra weight. Get regular exercise. And if you drink alcohol, do so in moderation. Also take your blood pressure medicines as prescribed.
  • Keep a record of your blood pressure at home. If your health care team will ask to do this, enter each blood pressure reading. Then, take the registration examinations.
  • Eat less protein. Ask your doctor if you should cut back on protein. This can help to decrease the IgA nephropathy from getting worse and to protect your kidneys.

Coping and support

Coping with severe forms of IgA nephropathy can be a challenge. But you don't have to do it alone. If you have questions or need help, talk with a member of your health care team.

It can also help to join a support group. You can meet other people who can understand what is happening and to share information with you. To find out about support groups in your area that deal with kidney disease, ask your health care team. Or contact the National Kidney Foundation (NKF) to learn about the NKF Peers, a national of a telephone-based peer support program. Call 855-NKF-PEER (855-653-7337) to join.

Preparing for your appointment

It is likely to start by seeing your primary care physician. But you may be referred to a doctor who is trained to diagnose and treat disorders of the kidney, called a nephrologist. Here are some tips to prepare for your appointment.

What you can do

Ask your doctor if you need to fast for a blood test or other restrictions.

Make a list of:

  • Your symptoms and when they began. Include any of the symptoms that do not seem to be related to the reason for your appointment.
  • All the medicines that you take. Are medicines that you buy without a prescription, vitamins, herbs and other supplements. Note the amount of medicine that you take, called the dose.
  • Questions to ask your doctor. This way you can make the most of their time together.

Ask a family member or friend to go with you to help you remember the information that you receive.

Questions to ask your doctor include:

  • What tests do I need?
  • What is the best course of action? How much time will I need medication?
  • Can I control this disease with diet and lifestyle changes?
  • I have other health conditions. How can I best manage these conditions?
  • Do you have printed material on this condition that I can have? What sites do you recommend?

What to expect from your doctor

Your doctor may ask you questions such as:

  • Do your symptoms occur often or once in a while?
  • How bad are the symptoms?
  • Does anything seem to make them better?
  • What, if anything, appears to worsen?
Symptoms and treatment of IgA nephropathy (Berger's disease)