IgA Nephropathy Autoimmune Kidney Disease

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

Immunoglobulin A nephropathy (IgA nephropathy) is a kidney problem that affects the glomeruli, which is an intricate network of blood vessels responsible for this blood-filtering 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 filter your blood. They send waste products and fluid (as urine) to the bladder and release blood and other larger molecules, like proteins, back into the bloodstream.

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 inflammation, and eventually scarring, which makes it difficult for the glomeruli to perform their filtering 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.

Symptoms

The most common symptom 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.

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, sore throat, or respiratory infection. 

Diagnosis

A healthcare provider 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 confirm the diagnosis, a nephrologist (a practitioner 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 healthcare providers 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 healthcare provider 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 (proteinuria).

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

Treatment

In people diagnosed with IgA nephropathy, about 20% to 40% 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 healthcare provider 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.

Additionally, the corticosteroid Tarpeyo (budesonide) may be prescribed to reduce increased protein levels in the urine in adults at risk of rapid disease progression.

Your healthcare provider may also treat the inflammation occurring with IgA nephropathy by giving you steroids like prednisone. Fish oil dietary supplements are also usually recommended.

If you progress to end-stage kidney disease, you may be treated with dialysis or a kidney transplant.

While kidney transplant 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 healthcare provider as advised.

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