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 available 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, along with lifestyle changes you can make to help you manage the disease. By working with your nephrologist (a doctor specializing in treating kidney diseases) and following your treatment plan, you may help prevent disease progression, lasting kidney damage, and kidney failure.
Immunoglobulin A nephropathy is a form of chronic kidney disease (CKD) that affects the delicate filtering units in your kidneys, known as glomeruli. Its name comes from the proteins made by your immune system known as 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 damage.
IgA deposits eventually affect your kidney function, 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:
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.
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 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. Studies show that ACE inhibitors are more effective than other types of medications in preventing kidney failure in people with IgA nephropathy.
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:
Anti-inflammatory medications like corticosteroids and immunosuppressants help dampen inflammation to better control your immune system.
Corticosteroids 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.
Your nephrologist may prescribe an oral corticosteroid such as prednisone. The U.S. Food and Drug Administration (FDA) has also approved the corticosteroid budesonide (Tarpeyo) for treating proteinuria in people with IgA nephropathy. While these medications work well to treat inflammation, they can also come with some unwanted side effects. Your doctor will likely prescribe a corticosteroid only for a short period of time to prevent side effects like:
Cyclophosphamide (Cytoxan) is another treatment option that dampens your immune system. This medication is often used as chemotherapy to treat cancer. It also helps treat IgA nephropathy by stopping immune cells from growing and dividing. Specifically, cyclophosphamide stops your immune system from making more antibodies that form immune complexes and cause kidney damage.
To clear out excess fluid from your body, your doctor may prescribe you a diuretic. Also known as water pills, diuretics help your kidneys release sodium to pull more water out of your bloodstream. The extra water is excreted from 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. Your doctor will prescribe a diuretic recommended for people whose kidneys don’t work as well as they should.
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 you 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:
Your doctor may also recommend making changes to your diet to help control your blood pressure and cholesterol levels. Salt causes your body to hang on to extra water — processed or prepared foods like canned foods and frozen dinners typically have added sodium. Try incorporating 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.
To help keep your cholesterol levels in check, you can:
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.
If you’re living with IgA nephropathy, talk with your doctor about steps you can take to better control your disease and keep your kidneys healthy. It’s important to follow your treatment plan to avoid damaging your kidneys more or developing kidney failure.
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.
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