Summary about Disease
Immunoglobulin A (IgA) nephropathy, also known as Berger's disease, is a kidney disease that occurs when an antibody called immunoglobulin A (IgA) builds up in your kidneys. This buildup results in local inflammation that, over time, can hamper your kidneys' ability to filter waste products from your blood. IgA nephropathy usually progresses slowly over years, but the course of the disease varies from person to person. Some people experience complete remission, while others develop end-stage renal disease (kidney failure).
Symptoms
Hematuria (blood in the urine): This may be microscopic (only detected in a urine test) or macroscopic (visible to the naked eye, making the urine appear pink, red, or cola-colored). Macroscopic hematuria often occurs during or after an upper respiratory infection, cold, flu, or strenuous exercise.
Proteinuria (protein in the urine): This is often detected during routine urine tests.
Swelling (edema): This may occur in your hands, feet, ankles, and sometimes around your eyes.
High blood pressure (hypertension):
Flank pain: Pain in your side or back.
Foamy urine: Which is caused by protein in the urine.
Causes
The exact cause of IgA nephropathy isn't known. It's considered an autoimmune disease, but the specific trigger is not fully understood. Possible factors include:
Genetics: The disease is not typically inherited, but certain genes may increase susceptibility.
Abnormal IgA: The IgA antibody in people with IgA nephropathy is structurally different from normal IgA. This abnormal IgA tends to form deposits in the kidneys.
Immune system dysfunction: This could involve an overproduction of IgA or problems with the clearance of IgA deposits.
Infections: Upper respiratory infections (colds, flu) may trigger episodes of hematuria.
Liver disease: Such as cirrhosis.
Celiac disease
Gluten intolerance
Medicine Used
There is no cure for IgA nephropathy, but medications can help manage symptoms and slow the progression of kidney damage. Treatment options may include:
ACE inhibitors or ARBs: These medications are used to lower blood pressure and reduce protein in the urine.
Corticosteroids: Such as prednisone, may be used to reduce inflammation and suppress the immune system.
Immunosuppressants: Other immunosuppressant medications, such as cyclophosphamide, azathioprine, or mycophenolate mofetil, may be used in more severe cases.
Statins: To lower cholesterol levels.
Fish oil supplements: Containing omega-3 fatty acids, may help reduce inflammation.
Diuretics: To reduce swelling.
Blood thinners: to reduce risk of blood clots.
Is Communicable
No, IgA nephropathy is not communicable. It is not caused by an infectious agent and cannot be transmitted from person to person.
Precautions
While there are no specific precautions to prevent IgA nephropathy, people with the condition can take steps to manage their health and slow the progression of kidney disease:
Control blood pressure: Through medication and lifestyle changes (diet, exercise, weight management).
Reduce protein intake: Following a diet low in protein may help reduce stress on the kidneys. Consult with a doctor and registered dietician.
Limit salt intake: To help control blood pressure and reduce swelling.
Avoid NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can harm the kidneys.
Manage cholesterol levels: Through diet and medication if needed.
Get regular checkups: Monitor kidney function and blood pressure.
Stay hydrated: Adequate fluid intake is important for kidney health.
Avoid smoking: Smoking can worsen kidney disease.
How long does an outbreak last?
The term "outbreak" is not typically used for IgA nephropathy. Episodes of macroscopic hematuria (visible blood in the urine) may occur during or after an upper respiratory infection or strenuous exercise. These episodes usually last for a few days to a week. However, the underlying kidney disease is chronic and can progress over many years.
How is it diagnosed?
Urine tests: To detect hematuria and proteinuria.
Blood tests: To assess kidney function (e.g., creatinine, BUN), electrolyte levels, and IgA levels.
Kidney biopsy: This is the most definitive diagnostic test. A small sample of kidney tissue is examined under a microscope to look for IgA deposits.
Timeline of Symptoms
The timeline of symptoms in IgA nephropathy is variable.
Early stages: Many people have no symptoms and the disease is detected during routine urine tests. Microscopic hematuria and proteinuria may be present.
Episodic macroscopic hematuria: This may occur intermittently, often triggered by upper respiratory infections or exercise.
Progressive disease: Over years, symptoms such as swelling, high blood pressure, and fatigue may develop as kidney function declines.
End-stage renal disease: In some cases, the disease progresses to kidney failure, requiring dialysis or kidney transplantation.
Important Considerations
Progression: The rate of progression of IgA nephropathy varies widely. Some people may have stable kidney function for many years, while others may experience more rapid decline.
Pregnancy: Women with IgA nephropathy should be closely monitored during pregnancy, as it can increase the risk of complications.
Risk factors for progression: Factors associated with a higher risk of progression include high blood pressure, proteinuria, impaired kidney function at diagnosis, and certain genetic factors.
Lifestyle modifications: Adopting a healthy lifestyle, including a low-sodium diet, regular exercise, and weight management, can help slow the progression of kidney disease.
Regular monitoring: Regular follow-up with a nephrologist (kidney specialist) is essential to monitor kidney function and adjust treatment as needed.