How is IgA nephropathy treated?

IgA nephropathy is very common disease, perhaps affecting several hundred million people around the globe. IgA nephropathy is a kidney disorder that occurs when IgA—a protein that helps us fight infections—settles in the kidneys. Although in many patients it is a rather benign disorder, it can progress to end-stage renal disease (ESRD).

The clinical features of IgA nephropathy are quite variable but episodes of hematuria, often combined with persistent proteinuria, are common. Usually, the passage of blood in the urine (macroscopic haematuria) making it coffee or tea coloured, is one of the signs for which the person sees a doctor. This is usually associated with a sore throat or respiratory infection or diarrhoea and vomiting, and may occur again in association with such infections. Nephrotic syndrome at presentation is uncommon.

How is IgA nephropathy treated?

Kidney disease usually cannot be cured. When the kidneys are damaged, they cannot be repaired. Treatment focuses on slowing the disease and preventing complications.

One complication is high blood pressure, also called hypertension. Hypertension damages the kidneys. Two types of blood pressure medicines called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) protect kidney function. These medicines not only lower blood pressure but also decrease the loss of protein into the urine. Because of this effect, they are often used in IgA nephropathy to protect the kidneys. They are good medicines but have certain side effects your doctor will warn you about. Pregnant women should not take ACE inhibitors or ARBs because they can damage the unborn baby.

People with IgA nephropathy may develop high cholesterol. Watching your diet and taking medications can help lower your cholesterol levels. Lowering cholesterol may help slow kidney damage.

Medicines such as prednisone may help treat IgA nephropathy. Prednisone belongs to a class of medicines called corticosteroids, which can have harmful side effects. In research studies, fish oil supplements containing omega 3 fatty acids also slowed kidney damage in some patients. Vitamin E may help lower protein in the urine but not blood. One of the newer immunosuppressive agents called mycophenolate mofetil (MMF) is also being tested in treating IgA nephropathy.


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