IgA nephropathy, also known as Berger’s disease, is a chronic kidney condition characterized by the abnormal accumulation of immunoglobulin A (IgA) proteins in the kidney’s filtering units known as glomeruli. This accumulation leads to inflammation, which can progressively damage the kidneys, potentially resulting in blood and protein in the urine and, in more severe cases, kidney failure. Though it affects individuals worldwide, the disease remains under-recognized, emphasizing the need for awareness and understanding.
IgA nephropathy is an autoimmune disorder where the body’s immune system produces defective IgA antibodies. These antibodies, instead of performing their defensive roles against infections, aggregate in the kidneys. The accumulation triggers inflammatory responses, disrupting the filtering process and impairing kidney function over time. Although the condition can affect people of all ages, it is most commonly diagnosed in young adults and is slightly more prevalent among males.
The clinical presentation of IgA nephropathy can vary significantly among individuals, with some experiencing mild symptoms and others progressing to severe kidney dysfunction. The disease is often silent in its early stages, but signs may include:
· Blood in the urine (hematuria): Often visible as tea-coloured or red urine.
· Protein in the urine (proteinuria): Detected during routine urine tests, it may cause foamy urine.
· High blood pressure: A common complication arising from kidney damage.
· Swelling (edema): Particularly in the hands, feet, or face due to fluid retention.
· Fatigue: Resulting from compromised kidney function and associated anaemia.
The precise cause of IgA nephropathy is not fully understood, but it is believed to stem from abnormalities in the production and clearance of IgA antibodies. Some potential contributing factors include:
· Genetic predisposition: Family history of IgA nephropathy or other autoimmune diseases increases the risk.
· Infections: Respiratory or gastrointestinal infections may exacerbate the condition.
· Environmental factors: Lifestyle habits and exposures may influence the progression.
While the disease is idiopathic in many cases, genetic studies have identified certain hereditary markers that suggest a familial link in some individuals.
Diagnosing IgA nephropathy involves a combination of clinical evaluation, laboratory testing, and, in some cases, kidney biopsy. Key diagnostic tools include:
· Urine tests: Detect blood and protein in the urine, which are hallmark signs of kidney damage.
· Blood tests: Assess kidney function, including levels of creatinine and urea.
· Imaging studies: Ultrasound may be used to examine the kidney structure.
· Kidney biopsy: The definitive test, where a small tissue sample is examined to confirm IgA deposition in the glomeruli.
Although there is no cure for IgA nephropathy, treatment focuses on managing symptoms and slowing disease progression. Therapies include:
· Medications:
· Angiotensin-converting enzyme (ACE) inhibitors: Help control blood pressure and reduce proteinuria.
· Immune-suppressing drugs: Such as corticosteroids in severe cases.
· Fish oil supplements: May have anti-inflammatory properties.
Lifestyle modifications: Dietary changes, regular exercise, and smoking cessation support kidney health.
Monitoring: Regular follow-ups to assess kidney function and adjust treatments.
Managing IgA nephropathy often requires patients to adopt a proactive approach to their health. Staying informed about the disease, adhering to treatment plans, and maintaining a healthy lifestyle can significantly improve quality of life. Support groups and counselling can also provide valuable emotional and practical assistance.
Continuous research in the field of nephrology has led to better understanding and novel approaches to treating IgA nephropathy. Emerging therapies, including biologics targeting immune pathways and gene-based treatments, hold promise for improving outcomes in the future. Early diagnosis and personalized care remain crucial in mitigating the disease’s impact.
IgA nephropathy is a complex and chronic kidney disease that requires thoughtful management and awareness. While it poses significant challenges, advancements in medical science and patient engagement offer hope for better outcomes. Early intervention, tailored therapies, and a commitment to maintaining kidney health can empower individuals to navigate the condition effectively.
IgAN & Me 