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IgA Nephropathy (Berger’s Disease)

In 1968, French nephrologist Dr. Jean Berger first described immunoglobulin A (IgA) nephropathy. Sometimes referred to as Berger’s disease, IgA nephropathy is a kidney disease that causes the kidneys to become inflamed. At first the disease was believed to be of little threat. But after more and more researchers looked into IgA nephropathy, it turned out that as many as 50 percent of the cases progressed to end stage renal disease (ESRD), or kidney failure, according to the IgA Nephropathy Support Network. After diabetes and high blood pressure, IgA nephropathy is the third leading cause of chronic kidney disease in the United States.

Immunoglobulin A is an antibody. Antibodies are produced when there is a virus, bacterium or toxin, threatening your body. Normally, these antibodies will help fight the thing that is invading your body. For reasons that are unknown, IgA can get into the kidney, causing inflammation. IgA can eventually lead to blood and protein in the urine, high blood pressure, swollen hands and feet and other signs of chronic kidney disease.

Symptoms of IgA nephropathy

Symptoms for IgA nephropathy do not occur at the beginning stages of the disease. IgA nephropathy is a progressive condition, and it can take decades before you experience any symptoms. Sometimes, during a routine screening your doctor may detect signs of IgA nephropathy. Symptoms of IgA nephropathy include: 

  • Cola or tea-colored urine, due to blood in the urine (hematuria)
  • Periodic pain in the loins, abdomen, sides or flanks
  • Foam after urination caused by protein in the urine (known as proteinuria)
  • Fatigue
  • Flu and cold-like symptoms
  • High blood pressure
  • Swelling of the hands and feet (edema)
  • Mood swings
  • Becoming more susceptible to allergies
  • Lack of response to cold temperatures (mainly in children)
  • Urinary tract infections (UTIs, mainly in young girls)

Even if you have no symptoms, a routine screening from your doctor can show signs of blood or protein in the urine. However, blood in the urine is not always a sign of serious illness. Sometimes it can be caused by a variety of things, such as intense exercise, kidney stones or bladder infections. Certain medications or contaminated foods you may eat can also be a cause. But if blood in the urine continues, you should talk to your doctor immediately, because this could be a symptom for IgA nephropathy.

What causes IgA nephropathy?

Anyone at any age can get IgA nephropathy although it is more common in men. Caucasians and Asians also have a higher incidence of IgA nephropathy than other ethnic groups.

It is still unknown how people develop IgA nephropathy and why IgA traps itself in the kidneys. In some cases IgA nephropathy can develop after a child or young adult has a viral infection of the upper respiratory or gastrointestinal tracts. For some people, a genetic defect may be linked to the development of IgA nephropathy.

IgA nephropathy and your kidneys

Acute kidney failure or chronic kidney disease can occur due to IgA nephropathy. In some cases of IgA nephropathy, a person’s kidneys will stop functioning suddenly and then after a time will begin functioning again. For those who have IgA nephropathy that leads to chronic kidney disease, after time — years or even decades — their kidneys will slowly stop functioning. Whether there is acute kidney failure or kidney function stops after time, dialysis will be necessary. Dialysis acts as a replacement for the kidneys by filtering the waste and toxins from your blood through a dialysis machine. A kidney transplant can be considered for those who have progressed to end stage renal disease.

How do doctors diagnose IgA nephropathy?

Blood in the urine is the most common symptom for IgA nephropathy. If blood or protein is found in your urine a series of blood and urine tests may be ordered by your doctor. These tests can usually determine if the kidneys are injured and how well they are working. Large amounts of IgA in your blood can sometimes be detected, but there are no specific blood or urine tests that can always determine whether kidney injury is due to IgA nephrolpathy, or if it is due to some other condition.

A kidney biopsy may be in order if your doctor believes it is a severe case. To perform a kidney biopsy, your doctor uses a special biopsy needle to remove tiny pieces of tissue from your kidneys for examination in determining if IgA has lodged itself into the glomeruli.

How do you treat IgA nephropathy?

IgA nephropathy cannot be prevented and has no cure. Some people are able to live with the disease without many complications. But half of the people who do get IgA nephropathy may progress to end stage renal disease. Your doctor will work with you to help treat this condition and may recommend:

  • High blood pressure medications (such as ACE inhibitors [angiotensin converting enzyme] prescribed by your doctor; helps reduce high blood pressure and slows progression of kidney disease)
  • Immunosuppressants (such as corticosteroids and methylprednisolone)
  • Omega-3 fatty acids (reduces inflammation in kidney)
  • Vitamin E (may be prescribed by your doctor; reduces protein in the urine)
  • Kidney diet (as planned by your dietitian)

Talk with your doctor about getting tested for IgA nephropathy and things you should and should not do if you’re diagnosed with the disease.

Summary

IgA nephropathy is a disease is the third leading cause of chronic kidney disease in the United States. Although it isn’t preventable and there isn’t a cure for IgA nephropathy, there are measures to take to treat this type of kidney disease. While some people are able to live with IgA nephropathy without a problem, it can lead to kidney failure in others. Talk with your doctor and get tested. If you are diagnosed with IgA nephropathy your doctor will treat the kidney disease and help you live a healthy life.

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