IgA nephropathy is a type of kidney disease that can contribute to long-term health complications. Early treatment and detection can help reduce your risk for complications.

Your kidneys play a vital role in your overall health. They work to detoxify your body but also regulate internal fluid balance and influence red blood cell production, among many other functions.

Diseases that affect your kidneys, like IgA nephropathy (IgAN), can interrupt these necessary biological processes. If left undetected or untreated, they can cause permanent damage and long-term health complications that may even become life threatening.

IgAN, also known as Berger disease, is a type of kidney disease. It’s one of the leading causes of kidney failure and glomerulonephritis — inflammation of the kidneys’ filtration structures called the glomeruli.

IgAN occurs when the immune system produces high levels of antibodies, particularly immunoglobulin A (IgA), which build up in the kidneys, causing inflammation in the glomeruli. Over time, this inflammation can lead to damage and scarring of the nephrons, where the glomeruli are located.

When your kidneys can’t filter properly, their ability to support your body’s functions declines. If there’s enough damage, your kidneys might not be able to keep up with demands, resulting in kidney failure.

How the condition progresses is unique to each person. Genetics, coexisting medical conditions, and environmental factors can all contribute to disease risk and severity.

Complications from IgAN can develop when damage in the kidneys prevents them from properly functioning.

As IgAN progresses, damage to the glomeruli and nephrons can lead to high blood pressure, also known as hypertension.

Inadequate kidney filtration can create a buildup of waste products like sodium and water, which can increase the volume of your blood. Increased blood volume means increased pressure within your blood vessels.

Kidney damage in IgAN can also cause proteinuria, which is the loss of protein through your urine. Proteinuria is associated with high blood pressure because it changes how effectively excess fluid moves from your tissues into the bloodstream.

If you have edema (where cells hold onto fluid), your body can increase your blood pressure to help move nutrients in your blood.

Nephrotic syndrome refers to a group of symptoms indicating your kidneys aren’t working at peak performance. Clinical markers of nephrotic syndrome include:

  • high urine protein levels
  • low blood protein levels
  • hyperlipidemia — high levels of cholesterol and other lipids in the blood

Signs you may be living with nephrotic syndrome include:

  • edema, or fluid retention in your extremities
  • extreme fatigue
  • weight gain
  • foamy or bubbly urine
  • loss of appetite

While nephrotic syndrome is often associated with kidney damage and failure over time, the effect it has on fluid balance and cholesterol levels can contribute to other chronic health conditions like anemia and heart disease.

Chronic kidney disease (CKD) is the progressive loss of kidney function over time. IgAN can be a cause of CKD, reducing kidney function as damage and scarring builds up over time.

CKD can increase your risk for other health conditions, such as:

  • hypertension (high blood pressure)
  • heart disease
  • acute kidney injury, which is a sudden decline in kidney function due to illness, injury, or medications

Kidney failure occurs when your kidneys can’t meet the basic level of function necessary to support your body’s needs. For some people, kidney failure can be sudden and short term. For others, it can develop slowly over time and be permanent.

In IgAN, approximately 1 in 5 people will develop kidney failure within 10 years after diagnosis.

Doctors tailor the management of IgAN to your individual needs. The overarching goals are to reduce problematic symptoms, slow kidney disease progression, and keep your kidneys functioning as best as possible.

Conservative therapy is the preferred approach due to an increased risk of complications from immunosuppressive therapies. With this management strategy, your doctor treats the clinical markers of IgAN, like hypertension and proteinuria, to help slow IgAN progression.

Angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, and other antihypertensive drugs are the mainstays of conservative treatment. These medications help control blood pressure and the loss of protein in your urine.

Your doctor may also consider:

  • sodium-glucose cotransporter-2 inhibitors
  • endothelin receptor [type A] antagonists

In advanced cases of IgAN, your doctor may opt for a course of immunosuppressive therapy to reduce the immune response underlying IgAN. These therapies may include corticosteroids, rituximab, cyclophosphamide, and other immunosuppressive agents.

Immunosuppressant therapy may not be right for you, and your doctor will carefully weigh the benefits against the risks before recommending this management course.

If IgAN has led to end stage renal disease, where kidney damage is extensive, a kidney transplant may be necessary.

Healthy lifestyle modifications like regular exercise, a balanced diet, and smoking cessation can support kidney health and reduce factors that contribute to kidney disease.

The warning signs of IgAN aren’t always obvious, especially in the early stages of the disease. Consider speaking with a doctor if you notice any of the common symptoms, such as:

  • pink or brown-colored urine (blood in the urine)
  • foamy or bubbly urine
  • edema in your legs or feet

If you already have a diagnosis of IgAN, contact your doctor whenever you notice changes in your existing symptoms, the appearance of new symptoms, or broader feelings of health effects, like appetite loss, body aches, or a persistent feeling of being unwell.

There is no cure for IgAN, but individual outlooks can vary. According to research, approximately 50% of people have a nonaggressive disease course. Early detection and treatment can significantly improve long-term outcomes.

A 2023 long-term cohort study in the United Kingdom on IgAN outcomes found that of more than 2,200 people living with IgAN, 50% reached kidney failure or end of life by the 10-year follow-up mark.

The average age at end of life was 48 years. Even among those considered “low risk” based on proteinuria levels, rates of kidney failure were high at the 10-year mark.

Hypertension, CKD, nephrotic syndrome, and kidney failure are potential complications of IgAN.

While there is no cure for this type of kidney disease, early detection and conservative treatment can slow the rate of kidney damage and help preserve your kidney function as long as possible. In the most severe cases, a kidney transplant may be necessary.