What is IgA Nephropathy

IgA nephropathy, or Berger’s disease, is a condition where proteins called IgA build up in the kidneys and causes damage. IgA is a type of protein called an antibody and is an important part of immunity because antibodies help activate the immune system. Nephropathy is any damage to the kidneys.

Causes

Nobody is sure what actually causes IgA nephropathy, but the disease can occur in two forms, either suddenly (acute disease) or slowly over many months or years (chronic disease). The disease does seem to have some genetic components in some people and is also associated with other conditions, including cirrhosis, celiac disease, dermatitis herpetiformis, and Henoch-Schonlein purpura. In addition, some infections may cause Berger’s Disease. In general, men are more at risk than women and Caucasians and Asians are more at risk than the general population.

Signs and Symptoms

In this disease, IgA is deposited in the kidneys and builds up inside the small blood vessels of the kidney to a point where structures in the kidney called glomeruli become very inflamed. The beginning stage of IgA nephropathy has no symptoms, however, the first sign of disease is usually blood in the urine once inflammation in the glomeruli begins to cause kidney damage. Swelling of the hands and feet can also occur, suggesting that there is too much protein in the urine. IgA nephropathy can also cause kidney failure with symptoms ranging from swelling, nausea, fatigue, headaches, and sleep problems. Unfortunately, once these symptoms become apparent, the damage to the kidneys may be permanent.

Diagnosing

Berger’s disease is usually diagnosed using a urinalysis, a urine test looking for the presence of blood and protein. If this test is positive, further examination of the urine is done where clumps of red blood cells are looked for under a microscope. If these clumps of cells are found, this usually indicates kidney damage. Additionally, blood tests can be done to check the function of the kidneys. If the waste products, urea nitrogen and creatinine, are found in high levels in the blood, this too indicates lowered kidney function. Finally, to confirm that IgA deposits are the cause of kidney damage, a biopsy of the kidney is performed, where a special needle is used to take a small piece of the kidney that can be examined under a microscope to look for IgA deposits.

Treatment

Unfortunately, there is no cure for IgA nephropathy and each patient has a unique disease course. Some people will have no complications and others only have mild symptoms, the remaining half of patients do progress to kidney disease and eventually kidney failure. High blood pressure and high cholestrol levels are both common side effects of Berger’s disease. Medication for each of these conditions not only helps lower blood pressure or cholesterol levels, but can also help protect further kidney damage by reducing the amount of protein in urine.

In addition, corticosteroids, such as prednisone, are immunosupressive drugs and may help reduce the level of IgA since these are a component of the immune system. This therapy is controversial, however, because corticosteroids have many side effects and are not necessarily proven to be effective. Omega-3 fatty acids (found in fish, flax seeds, and eggs and meat from grass-fed animals) may also reduce inflammation without the harmful side effects of steroid therapy.

The National Institute of Diabetes and Digestive and Kidney Diseases

The Mayo Clinic

The National Institutes of Health – Medline

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