Your kidneys play an important role in keeping you healthy. They make sure your fluid, salt, and hormone levels are balanced, regulate your blood pressure, and help your body get rid of waste. If you’re living with immunoglobulin A (IgA) nephropathy — also known as Berger’s disease — kidney damage can interfere with all of these necessary processes. Fortunately, there are several treatment options to help you better control your blood pressure and reduce inflammation caused by IgA nephropathy.

Read on to learn more about how IgA nephropathy is treated and lifestyle changes you can make to help manage the disease. By working with your nephrologist (a doctor specializing in treating kidney diseases) and following your treatment plan, you may be able to help prevent disease progression, lasting kidney damage, and kidney failure.

What Is IgA Nephropathy?

IgA nephropathy is a form of chronic kidney disease that affects the delicate filtering units in your kidneys, known as glomeruli. Its name comes from the proteins your immune system makes, called IgA antibodies. Normally, these antibodies help protect you against bacteria and viruses in your digestive tract, nose, and lungs.

However, people with IgA nephropathy have abnormal IgA antibodies, which their immune systems recognize as foreign. As other antibodies attach to IgA antibodies to tag them for destruction, they form clumps called immune complexes that travel around the body in the bloodstream. These complexes are too large for the glomeruli to filter in the kidneys, so they become stuck in the form of IgA deposits, causing inflammation and kidney damage.

IgA deposits eventually affect your kidneys, making it harder for your body to get rid of extra fluid and waste. Damaged kidneys also leak blood and proteins, so you may begin to notice symptoms such as:

• Edema — Swelling in your legs or feet caused by fluid buildup in your body
• Hypertension — Increased blood pressure
• Proteinuria — Protein in your urine, making it foamy or frothy
• Hematuria — Blood in your urine, which gives it a pink or red color

Left untreated, IgA nephropathy continues to progress and may eventually lead to kidney failure, also known as end-stage renal disease, or ESRD. In fact, around 45 percent of people with IgA nephropathy develop kidney failure within 20 years of being diagnosed. The only treatments available for kidney failure are dialysis or a kidney transplant.

It’s important to follow your treatment plan to keep your kidneys as healthy as possible. Here are five treatments your nephrologist may recommend for IgA nephropathy to help maintain your kidney function.

1. Blood Pressure Medications Reduce Strain on Blood Vessels

Many people with IgA nephropathy have high blood pressure because their kidneys can’t filter out extra fluid from the bloodstream. This increases the amount of blood in your body, putting more force and pressure on the walls of your blood vessels. High blood pressure also puts extra strain on the delicate blood vessels in your kidneys, causing more damage.

Fortunately, there are several medications available to help control your blood pressure. Some target angiotensin, a hormone responsible for narrowing your blood vessels. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) work by relaxing and opening your blood vessels, allowing more blood to flow through with less pressure. Studies show that ACE inhibitors are more effective than other types of medications in preventing kidney failure in people with IgA nephropathy.

ACE inhibitors and ARBs work by relaxing and opening your blood vessels, allowing more blood to flow through.

Your doctor may also prescribe you a beta-blocker, which works by lowering your heart rate and your heart’s pumping force. Calcium channel blockers prevent your blood vessels from using calcium, which normally makes them narrow. Blocking calcium opens your blood vessels and lowers your blood pressure.

Examples of blood pressure medications you may be prescribed include:

• Sparsentan (Filspari), an angiotensin 2 receptor antagonist approved by the U.S. Food and Drug Administration (FDA) to reduce proteinuria in adults with IgA nephropathy who are at high risk for progression
• ACE inhibitors — Lisinopril (Zestril) and benazepril (Lotensin)
• ARBs — Losartan (Cozaar) and valsartan (Diovan)
• Beta-blockers — Atenolol (Tenormin) and metoprolol (Lopressor)
• Calcium channel blockers — Diltiazem (Cardizem) and verapamil (Verelan)

2. Steroids and Immunosuppressants Stop Immune System Attacks on Your Kidneys

Anti-inflammatory medications like corticosteroids (steroids) and immunosuppressants help reduce inflammation to better control your immune system.

Steroids are synthetic or laboratory-made hormones that help prevent your immune system from attacking your kidneys. It’s important to note that corticosteroids aren’t the same as steroid drugs used by bodybuilders and athletes.

Steroids and other drugs that suppress the immune system may also be used to treat IgA nephropathy. A new drug, iptacopan (Fabhalta), was approved in 2024.

Your nephrologist may prescribe an oral steroid such as prednisone. The FDA has also approved the steroid budesonide (Tarpeyo) for treating proteinuria in people with IgA nephropathy. While these medications work well to treat inflammation, they can also come with unwanted side effects. Your doctor will likely prescribe a steroid only for a short time to prevent side effects like:

• High blood pressure
• Swelling in your face, hands, and legs
• Weight gain
• Excess hair growth
• Acne

Doctors sometimes recommend combining cyclophosphamide (Cytoxan) with steroids for people whose IgA nephropathy is progressing rapidly. This medication is often used as chemotherapy to treat cancer. It also helps treat IgA nephropathy by stopping immune cells from growing and dividing.

Iptacopan

In August 2024, the FDA approved iptacopan (Fabhalta) to treat proteinuria in people with IgA nephropathy. Iptacopan is a complement inhibitor, a drug that reduces the action of the complement system. The complement system is one part of the immune system that’s involved in kidney injury in IgA nephropathy. Iptacopan is taken orally twice a day.

A clinical trial is a research study that tests how well new medical treatments work in people. In clinical trials, participants took either iptacopan or a blood pressure medication. Results showed that iptacopan was significantly more effective at reducing proteinuria compared with the blood pressure medication.

3. Diuretics Help Kidneys Release Sodium

To clear out excess fluid from your body, your doctor may prescribe a diuretic. Also known as water pills, diuretics help your kidneys release sodium to pull more water out of your bloodstream. The extra water comes out of your body as urine. You’ll notice you need to urinate more often when taking a diuretic.

Not only do these medications help treat swelling caused by IgA nephropathy, they also lower your blood pressure. If your kidneys don’t work as well as they should, your doctor will prescribe a diuretic.

4. Cholesterol Medications Prevent Fatty Buildup in Blood Vessels

IgA nephropathy can also affect your cholesterol levels. Long-term inflammation raises your low-density lipoprotein (LDL), or “bad” cholesterol, levels. Over time, cholesterol can build up in fatty deposits in your blood vessels, putting you at risk for other health complications like a heart attack or stroke.

Your doctor may prescribe a cholesterol-lowering medication like a statin if your levels are too high. Statins work by stopping your liver from making too much cholesterol. They also help your body clear out extra cholesterol in your bloodstream.

Examples of statins include:

• Atorvastatin (Lipitor)
• Simvastatin (Zocor)
• Rosuvastatin (Crestor)

5. Dietary Changes Can Help Protect Your Kidneys

Your doctor may also recommend making changes to your diet to help control your blood pressure and cholesterol levels. Limiting your salt intake is the first step. Salt causes your body to hang on to extra water. Processed or prepared foods like canned foods and frozen dinners typically have added sodium. Eating nutrient-rich foods like whole foods rather than preprocessed foods can also boost your body’s defense against inflammation. Try adding fresh fruits and vegetables into your diet as often as you can and cook your meals at home. This helps you control the amount of salt in your food.

Your health care provider may suggest cutting back on protein as a way to protect your kidneys.

To help keep your cholesterol levels in check, you can:

• Bake or grill foods rather than frying them.
• Choose lean proteins like chicken, fish, beans, and low-fat dairy products.
• Use heart-healthy oils like olive or avocado oil instead of butter.
• Look for foods low in trans and saturated fats.

Finally, your health care provider may suggest cutting back on protein as a way to protect your kidneys. The proteins you eat are broken down into waste products that need to be filtered out of your blood. Eating too much protein puts extra strain on your kidneys, especially when living with IgA nephropathy. Your doctor can help you find the right amount of protein your body needs to function — cutting back too much can lead to malnutrition. In addition, if your kidney disease is advancing, your doctor will also recommend cutting down food high in potassium and phosphorus, as these minerals may build up in your blood and cause harmful effects.

Ask Your Doctor About IgA Nephropathy Treatment

If you’re living with IgA nephropathy, talk with your nephrology team about steps you can take to better control your disease and keep your kidneys healthy. It’s important to attend all follow-ups and stick to your treatment plan to avoid damaging your kidneys more or developing kidney failure.

Talk With Others Who Understand

At MyKidneyDiseaseCenter, the site for people with kidney disease and their loved ones, people come together to gain a new understanding of kidney disease and share their stories with others who understand life with kidney disease.

Are you living with IgA nephropathy? What treatments are you using to manage it? Share your experiences in the comments below.