IgA nephropathy
Kidney disease is a sneaky thing.
There may be no symptoms at all for
a long time while it is developing.
This means that unfortunately, many
people never realize they have a
kidney problem until a symptom such
as back pain or blood in the urine
appears.
This is true for IgA nephropathy.
It is not a disease that is
routinely tested for in many
countries (such as the United
States), and although it seems to
run in families, it can occur in
anyone and not be associated with
any other disease.
What is it?
IgA nephropathy is a form of
glomerulonephritis. Damage is caused
in the kidney by the abnormal
buildup of a protein (IgA). Research
suggests that this is due to an
autoimmune disorder (involving the
body's immune system). What starts
the disease in motion is not yet
known. |
Who gets it?
In the United States, Canada, and the United
Kingdom, IgA nephropathy accounts for 2-10% of
glomerular kidney diseases, but in Japan, it
accounts for 18-40%. It often begins in older
children or young adults in their 20s and 30s. The
disease occurs more often in males, and is rare in
blacks. It seems to run in families, which suggests
that genetics play a part in who develops it.
How is it diagnosed?
The most common symptom of IgA nephropathy is blood
in the urine, which causes the urine to look
tea-colored. To confirm the diagnosis, a small piece
of kidney tissue must be removed (biopsy) and
examined. There is some concern that IgA nephropathy
may actually be less rare than thought, since some
people may have it but without the biopsy the
disease wouldn't be detected.
How is it treated?
One of the most serious consequences of IgA
nephropathy is that the kidney becomes so damaged
that it stops working, called end-stage kidney
failure or end-stage renal disease (ESRD). This will
happen in about 30-40% of people with the disease.
There is a lack of agreement among researchers about
how to best prevent ESRD from happening in IgA
nephropathy. Some of the current treatments are:
- Control of high blood pressure with diet and
medication
- Steroids such as prednisone
- Drugs to suppress the immune system, such as
Imuran, Cytoxan, or CellCept
- Fish oil dietary supplements
If one or both kidneys fail, their function has to
be replaced either by dialysis or kidney transplant.
What is the outlook?
As many as 50% of people with IgA nephropathy don't
develop serious disease. Studies are trying to
discover how to best prevent the disease from
becoming kidney failure, or even how to reverse the
disease's effects. Future research could look for
how the disease occurs, and how to easily test for
its presence so that early treatment could be
started.
