10/30/2018 IgA Nephropathy Autoimmune Kidney Disease

UROLOGICAL HEALTH KIDNEY DISEASE

IgA Nephropathy Autoimmune Kidney

Disease
By Mary Kugler, RN | Reviewed by a board-certi ed physician
Updated September 08, 2018

Peter Dazeley/Photographer's Choice/Getty Images

Your kidneys are two bean-shaped organs located below your rib cage. Their main
function is to lter blood in order to rid the body of waste and extra uid.

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Immunoglobulin A nephropathy (IgA nephropathy) is a kidney problem that a ects

the glomerulus, which is an intricate network of blood vessels responsible for this
blood- ltering function.

Each of your kidneys contains about one million nephrons, and each nephron contains
a glomerulus. These glomeruli or mass networks of blood vessels delicately lter your
blood. They send waste products and uid (as urine) to the bladder and release blood
and other larger molecules, like proteins, back into the bloodstream.

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Normally, a person's immune system releases the antibody, immunoglobulin A, in

response to some sort of trigger like a viral infection. But in people with IgA
nephropathy, the immunoglobulin A builds up and deposits itself within the glomeruli
of their kidneys.

This immunoglobulin A buildup causes kidney in ammation, and eventually scarring,

which makes it di cult for the glomeruli to perform their ltering function. As a
result, kidney failure may occur.

Statistics
In North America, about twice as many males than females have IgA nephropathy, and
this pertains to both children and adults. In addition to being more common in males,
IgA nephropathy is more common in Caucasians and Asians and rare in African-
Americans.

Lastly, in the United States, over half of adults, age 30 years or older at the time of
diagnosis of IgA nephropathy, have stage 3 to stage 5 chronic kidney disease. This
suggests that diagnosing IgA nephropathy earlier may be bene cial, as treatment
could potentially slow down a person's kidney function decline.

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Symptoms
The two most common symptoms of IgA nephropathy are blood in the urine, which
causes the urine to look tea-colored, and protein in the urine, which may cause the
urine to appear foamy.

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However, the majority of people with IgA nephropathy have no symptoms. If a person
does note gross blood in their urine, and they have IgA nephropathy, it's usually after
a viral infection like a cold or the stomach u. 

Diagnosis
A doctor may suspect you or a loved one has IgA nephropathy based on a careful
history, as well as evidence on urine and blood tests. To con rm the diagnosis, a
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nephrologist (a doctor who specializes in kidney diseases) will remove a small piece of
kidney tissue. This procedure is called a biopsy and is done by placing a needle into
your back, where a kidney can be easily accessed. 

After the biopsy, a pathologist will examine the kidney tissue under a microscope and
stain it to see whether or not IgA deposits are present. If there is evidence of IgA
buildup, this will solidify the diagnosis of IgA nephropathy. 

It's important to note that doctors do not necessarily perform a kidney biopsy on
every person who has microscopic blood or protein in their urine.

Instead, if you have blood or protein in your urine, your doctor may monitor your
urine and kidney function every six to twelve months or so. He may then perform a
biopsy if your kidney function begins to decline (as evidenced by an elevated
creatinine level on a blood test) or you begin to have increased amounts of protein loss
in your urine.

Having high blood pressure may also be a reason why your doctor performs a kidney
biopsy (if there is also blood and/or protein in the urine).

Treatment
In people diagnosed with IgA nephropathy, up to half will very slowly (over years to
decades) develop end-stage kidney failure (called end-stage renal disease, or ESRD).

Depending on a number of factors related to your IgA nephropathy, your doctor may
treat you with medications to slow down the progression of your kidney disease. These
medications include angiotensin-converting enzyme (ACE) inhibitors or angiotensin II
receptor blockers (ARBs) to control your blood pressure. Fish oil dietary supplements
are also usually recommended.

Your doctor may also treat the in ammation occurring with IgA nephropathy by
giving you steroids like prednisone.
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If you progress to end-stage kidney disease, you may be treated with dialysis or a
kidney transplant.

While kidney transplant

Advertisement is an option, it's not considered a cure, as the IgA

nephropathy can reoccur in the newly transplanted kidney.

A Word From Verywell

Whether you or a loved one has been diagnosed with IgA nephropathy, another kidney
disease, or have been found to have blood and/or protein in your urine, be sure to
follow up with your doctor as advised.

This remains especially true with IgA nephropathy, as it's very di cult for doctors to
predict who will be OK and who will develop end-stage kidney disease.

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