IgA nephropathy (Berger disease)
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IgA nephropathy, also known as Berger’s disease, is a kidney disorder characterized by the accumulation of a germ-fighting protein called immunoglobulin A (IgA) in the kidneys. This leads to inflammation, causing gradual impairment in the kidney’s ability to filter waste from the blood.
The progression of IgA nephropathy varies among individuals, with some experiencing only blood in their urine without other complications. Others may face more severe issues, such as protein leakage in the urine and a decline in kidney function, which can ultimately lead to kidney failure.
While there is currently no cure for IgA nephropathy, medical interventions can help slow down its advancement. Treatment focuses on reducing inflammation, minimizing protein leakage, and preventing kidney failure. Some individuals may achieve a state of remission where the disease becomes inactive. Additionally, managing blood pressure and cholesterol levels can contribute to slowing down the disease’s progression.
Symptoms
In the early stages, IgA nephropathy often remains asymptomatic, and individuals may not experience any noticeable health effects for a decade or more. Occasionally, the presence of the disease is detected through routine medical examinations, where signs like protein and red blood cells in the urine, visible under a microscope, may be observed.
Symptoms of IgA nephropathy may include the following:
- Presence of blood in urine.
- The urine appears foamy due to protein spilling into the urine. Proteinuria is the medical term for this.
- Blood causes cola or tea-colored urine. These color changes may appear after a cold, sore throat, or respiratory infection.
- Back pain on one or both sides, below the ribcage.
- Elevated blood pressure.
- Fatigue and feeling weak.
- Edema, or swelling of the hands and feet.
If the condition progresses to renal failure, the following symptoms may occur:
- Confusion
- Stomach problem
- Vomiting
- Skin itchiness or rashes
- Cramping of the muscles
- Loss of appetite
- The mouth has a metallic taste.
If you suspect you have symptoms of IgA nephropathy, it’s crucial to seek medical attention promptly. Seeing a doctor is particularly important if you observe blood in your urine, as this could be a sign of a significant health issue, though other conditions can also cause this symptom. Additionally, if you experience persistent or recurring blood in the urine or sudden swelling in your hands or feet, it’s essential to get a checkup as these could be indicators of kidney problems. Timely medical intervention, such as dialysis or a kidney transplant, can be life-saving and greatly extend life expectancy for those facing kidney failure.
Causes
The kidneys, two bean-shaped organs located on either side of the spine, play a vital role in filtering waste, excess water, and other substances from the blood through tiny blood vessels known as glomeruli. These glomeruli act as filters, returning the purified blood to the circulation while eliminating waste products through urine. However, in the case of IgA nephropathy, a condition where the antibody protein Immunoglobulin A (IgA) accumulates in the glomeruli, it leads to inflammation and impairs their filtering function, ultimately affecting kidney health over time.
The precise cause of IgA nephropathy, a condition characterized by IgA build-up in the kidneys, remains unknown. However, certain factors have been associated with its development:
- Genetic predisposition: IgA nephropathy is observed to be more prevalent in specific families and particular ethnic groups, notably among individuals of Asian and European descent.
- Liver diseases: Conditions such as cirrhosis (liver scarring) and chronic hepatitis B and C infections have been linked to IgA nephropathy.
- Celiac disease: The consumption of gluten, a protein found in most grains, can trigger this digestive condition and may be related to IgA nephropathy.
- Infections: Certain infections, such as HIV and certain bacterial infections, have been suggested to have a connection with the development of IgA nephropathy.
Risk factors
The cause of IgA nephropathy remains unknown. However, certain factors have been associated with an increased risk of developing the condition:
- Sex: In North America and Western Europe, IgA nephropathy is at least twice as prevalent in men as it is in women.
- Ethnicity: The condition is more commonly observed in individuals of white and Asian descent than in those of African-American ethnicity.
- Age: IgA nephropathy predominantly manifests between the mid-teens and mid-30s.
- Family history: There is evidence to suggest that IgA nephropathy may run in some families, indicating a genetic predisposition to the condition.
Diagnosis
If you observe blood in your urine, you may have IgA nephropathy. Or a regular examination could reveal that your urine contains protein or blood. You’ll also require other tests. They may consist of:
- Urine tests. A laboratory can examine a urine sample under a microscope to assess kidney function and measure the amount of protein being excreted by the kidneys. In the case of IgA nephropathy, the lab examination may reveal the presence of blood in the urine or other indications of inflammation in the glomeruli, which are the small filters within the kidneys.
- Blood examination. The estimated glomerular filtration rate (eGFR) is a blood test used to assess the rate at which your kidneys are filtering your blood every minute. It provides valuable information about your kidney function and helps in the diagnosis and monitoring of kidney health.
- Kidney biopsy. This procedure is the definitive method to confirm the presence of IgA nephropathy. It involves using a specialized needle to extract small samples of kidney tissue, which are then examined under a microscope. This microscopic analysis of the tissue allows for an accurate diagnosis of IgA nephropathy.
- Iothalamate clearance test. This test might also be suggested by your doctor. It monitors how effectively your kidneys are filtering waste using a specific contrast agent.
Treatment
The IgA nephropathy condition is incurable. Additionally, it is impossible to anticipate with certainty how the condition will affect your health over time. Some patients just require medical testing to determine whether their sickness is progressing.
For others, medications can help control symptoms and prevent the condition from progressing.
Treatment options for IgA nephropathy include:
- Medication to control blood pressure. Blood pressure can be lowered and the amount of protein the body loses by using medications referred to as ACE inhibitors and Angiotensin Receptor Blockers (ARBs).
- Medications to control cholesterol level. This kind of medication can help you manage your excessive cholesterol and prevent kidney damage.
- Diuretics. These can aid in reducing edema or swelling in the hands and feet.
- Immunosuppressants. These are additionally known immune system calming medications. Corticosteroids and other potent medications that can weaken the body’s defenses are among them. The immune system’s production of the proteins that assault the glomeruli may be prevented by them. Serious adverse effects from these medications include an increased risk of infection, high blood pressure, and high blood sugar. Your doctor offers advice to you when you select an immunosuppressant. Numerous novel therapies have received approval or are undergoing clinical trials. Discuss the most recent developments in the treatment of IgA nephropathy with your doctor.
- Omega-3 fatty acids. These beneficial lipids may reduce glomeruli inflammation without having negative side effects. Omega-3s are available in fish oil supplements. But avoid picking things up off the shelf. Ask your doctor if taking fish oil pills on a prescription could be beneficial.
The main objective of treatment is to prevent you from requiring kidney transplantation or dialysis. However, if your kidneys fail to function adequately on their own, either of those procedures may be lifesaving.
