IgA nephropathy (Berger disease)

Overview

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.