Definition

IgA nephropathy is a kidney disorder characterized by blood in the urine. It is caused by inflammation of internal kidney structures and the deposit of IgA antibodies in kidney tissue.

It is also called Berger’s disease.

Alternative Names

Causes, incidence, and risk factors

IgA nephropathy (Berger's disease) is a form of mesangial proliferative nephritis. It occurs when abnormal deposits of immunoglobin A build up inside the small blood vessels of the kidney. Structures in the kidney called glomeruli become inflamed.

The disorder can appear suddenly (acute), or progress slowly over many years (chronic glomerulonephritis).

Risk factors include having a personal or family history of IgA nephropathy or Henoch Schonlein purpura, a form of vasculitis that affects many parts of the body, and may cause a kidney lesion that is identical to the lesion of Berger's disease.

IgA nephropathy can occur in persons of all ages, but most often affects males in their teens to late 30s.

Symptoms

• Changes in color of urine - bloody, dark, brown, or rust colored
• Repeated episodes of dark or bloody urine

Signs and tests

IgA nephropathy usually is discovered after one or more episodes of dark or bloody urine in a person with no other symptoms of kidney disorder.

Bloody urine may begin during or soon after a respiratory infection.

There are no specific changes seen during a physical examination. Occasionally, blood pressure may be high or swelling of the body may be present.

Tests that may be done include:

• Urinalysis
• Kidney biopsy (confirms the diagnosis)
• Urine immunoelectrophoresis

Treatment

The goal of treatment is to relieve symptoms and prevent or delay chronic renal failure.

Medicines may be given to control high blood pressure and swelling (edema). Controlling blood pressure is the most important measure to delay kidney damage.

Corticosteroids, other immunosuppressive drugs, and fish oil have also been used to treat this disorder.

Salt and fluids may be restricted to control swelling. A low to moderateprotein diet may be recommended in some cases.

Support Groups

For additional information and support, see the IgA Nephropathy Support Network website (www.igansupport.org).

Expectations (prognosis)

IgA nephropathy progresses slowly. In many cases, it does not progress at all. High blood pressure, large quantities of protein in the urine, and increased BUN or creatinine levels (blood tests that reflect kidney functioning) indicate a higher risk for progression of the disorder.

About 25% of people with IgA nephropathy develop end-stage kidney failure within about 25 years.

Complications

• Acute nephritic syndrome or nephrotic syndrome
• Chronic kidney failure
• End-stage kidney disease

Calling your health care provider

Call your health care provider if you have bloody urine or if your urine output decreases.

Prevention

Images

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