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Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on June 18th, 2023.
Key Takeaways
- This condition develops when abnormal IgA antibodies form immune complexes that deposit in kidney glomeruli, triggering inflammation that can progress over 10-20 years to end-stage renal disease.
- Gross hematuria (visible blood in urine) often appears 1-3 days after upper respiratory infections, while microscopic blood and protein levels above 1g/day indicate more severe kidney damage.
- Men develop the disease twice as frequently as women, with peak diagnosis occurring between ages 20-40, and Asian populations showing higher prevalence rates than Caucasians.
- ACE inhibitors or ARBs should target blood pressure below 130/80 mmHg and can reduce proteinuria by 30-50%, while corticosteroids may be considered when protein loss exceeds 1g/day despite optimal blood pressure control.
- Restricting dietary protein to 0.8g/kg body weight daily and limiting sodium to 2g/day helps reduce kidney workload, while omega-3 fish oil supplements at 4-6g daily may slow disease progression.
IgA nephropathy is a chronic kidney disease that affects the filtering units (glomeruli) inside the kidneys. This disorder is caused by the buildup of immune complexes and a protein called immunoglobulin A (IgA) within the glomeruli. If left untreated, IgA nephropathy can lead to progressive kidney damage and, eventually, end-stage renal disease.
What Causes IgA Nephropathy?
The exact cause of IgA nephropathy is not well understood. However, researchers believe that a combination of genetic and environmental factors may contribute to the development of this disorder. IgA is a normal part of the body's immune system, but in some individuals, the immune system may trigger the formation of IgA deposits and other immune protein complexes in the glomeruli.
Symptoms of IgA Nephropathy
The symptoms of IgA nephropathy may include:
Blood and protein in the urine
Swelling in the hands and feet
High blood pressure
Progressive kidney disease
Risk Factors for IgA Nephropathy
Certain risk factors may contribute to the progression of IgA nephropathy, including:
High blood pressure
Smoking
Excess weight or obesity
Managing these risk factors can help slow the progression of the disease and prevent complications.
Treatment Options for IgA Nephropathy
While there is no cure for IgA nephropathy, treatment focuses on slowing the progression of the disease and preventing complications. Treatment options may include:
Managing high blood pressure with medications
Limiting protein intake to reduce waste buildup in the blood
Losing excess weight to reduce proteinuria and kidney damage
Quitting smoking to protect blood vessels in the kidneys
Using medications such as steroids, immunosuppressants, or biologic drugs to reduce kidney damage and disease progression
If IgA nephropathy progresses to end-stage renal disease, patients may require dialysis or a kidney transplant.
Resources for Patients with IgA Nephropathy
Several organizations offer support and information for patients with IgA nephropathy, including:
By understanding the causes, symptoms, and treatment options for IgA nephropathy, patients can work with their healthcare providers to manage this chronic kidney disease and maintain their quality of life.
The Bottom Line
Early blood pressure control and dietary modifications can significantly slow kidney function decline in this progressive immune-mediated disease. The key is maintaining strict BP targets and monitoring proteinuria levels every 3-6 months to adjust treatment intensity. If you're noticing blood in your urine or unexplained swelling, Doctronic can help you get quick answers and determine if further kidney evaluation is needed.
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