IgA nephropathy, also known as Berger’s disease, is a chronic kidney disorder where immunoglobulin A (IgA) builds up in the kidneys, causing inflammation and potential damage. While there’s no definitive cure, treatment focuses on slowing disease progression, managing symptoms, and protecting kidney function. This guide explores the main treatment options, medications, lifestyle measures, and new therapies available for individuals diagnosed with IgA nephropathy.

Understanding IgA nephropathy

IgA nephropathy is an autoimmune condition where the immune system produces abnormal IgA that deposits in kidney filters (glomeruli), leading to inflammation. Over time, this may impair the kidneys’ ability to filter waste effectively. Symptoms can include blood in urine, swelling, and high blood pressure. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), early detection and consistent management are key to preserving kidney health.

Goals of treatment

Treatment aims to:

– Control blood pressure: High blood pressure accelerates kidney damage.

– Reduce proteinuria: Lowering protein levels in urine helps protect kidney function.

– Manage inflammation: Targeted medications reduce immune-related injury.

– Preserve kidney function: Slowing progression to chronic kidney disease (CKD) or kidney failure.

– Address symptoms: Managing swelling, fatigue, and other complications for quality of life.

Medications used in IgA nephropathy

Most patients require medication to stabilize kidney health and reduce risks. The Mayo Clinic outlines the main classes:

– ACE inhibitors or ARBs: Medications like lisinopril or losartan lower blood pressure and proteinuria.

– SGLT2 inhibitors: Drugs such as dapagliflozin can improve kidney outcomes in chronic kidney disease patients.

– Immunosuppressants: Corticosteroids (prednisone) or drugs like budesonide may be used to reduce inflammation.

– Omega-3 fatty acids: Fish oil supplements may modestly reduce inflammation in some cases.

– Diuretics: Used to manage fluid retention and swelling.

Lifestyle changes for kidney protection

Daily habits significantly influence disease progression. The National Kidney Foundation recommends the following:

– Follow a low-sodium diet: Keeps blood pressure under control.

– Limit protein intake: Reduces workload on kidneys; consult a renal dietitian.

– Stay hydrated: Supports kidney filtration and prevents dehydration-related stress.

– Avoid smoking and alcohol: Smoking worsens kidney damage; alcohol can affect blood pressure.

– Maintain a healthy weight: Reduces risk factors for hypertension and diabetes.

Monitoring and follow-up care

Regular monitoring helps detect early signs of kidney decline or treatment side effects:

– Blood tests: Track creatinine, eGFR, and kidney function markers.

– Urine tests: Measure protein and blood levels in urine.

– Blood pressure checks: Keep levels within target range (usually below 130/80 mmHg).

– Specialist visits: Regular nephrologist consultations for medication adjustments.

– Imaging scans: Occasionally used to assess kidney structure.

Guidelines from KDIGO (Kidney Disease: Improving Global Outcomes) recommend structured monitoring every few months depending on disease severity.

Advanced treatments and research

Recent advancements have introduced new options for patients with persistent inflammation or proteinuria:

– Targeted-release budesonide (Tarpeyo): Designed to deliver steroids directly to the gut immune system, minimizing side effects.

– Clinical trials: Ongoing studies explore biologic drugs and complement inhibitors to modulate immune response.

– Kidney transplant: For end-stage kidney failure, transplantation offers the best long-term outcome.

Research supported by ClinicalTrials.gov continues to expand options for patients with severe disease.

Managing complications

In addition to slowing disease progression, managing complications is critical:

– High blood pressure: Treated with ACE inhibitors, ARBs, and lifestyle modifications.

– Edema (swelling): Managed with salt restriction and diuretics.

– Chronic kidney disease: Requires dietary management, medications, and close monitoring.

– End-stage renal disease: Dialysis or transplantation becomes necessary if kidney function fails.

When to see a doctor

Contact a nephrologist promptly if you experience:

– Persistent blood in urine

– Swelling in legs, hands, or face

– Uncontrolled high blood pressure

– Foamy urine (sign of proteinuria)

– Fatigue or reduced urine output

Final thoughts

While IgA nephropathy currently has no cure, timely diagnosis and comprehensive management can slow progression and preserve kidney function. Combining medication, lifestyle changes, and regular monitoring under a nephrologist’s guidance offers the best outcomes. Stay informed through reputable sources like the Mayo Clinic, NIDDK, and KDIGO, and discuss new treatment options with your care team for personalized care.