IgA nephropathy is a kidney condition in which an antibody called immunoglobulin A, or IgA, accumulates in the kidney's filtering units. This can cause inflammation and damage to the glomeruli, potentially affecting kidney function over time.

The condition can behave very differently from one person to another. Some people have mild disease that remains stable for years, while others develop persistent protein in the urine, high blood pressure or progressive loss of kidney function.

Because of this variation, IgA nephropathy treatment needs to be individualized according to kidney function, urine protein levels, blood pressure, biopsy findings and the patient's overall risk of progression.

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, a super specialist nephrologist and transplant physician, provides specialized evaluation and management for IgA nephropathy and other kidney disorders.

What is IgA nephropathy?

IgA nephropathy is a type of glomerular kidney disease.

The glomeruli are tiny filtering structures inside the kidneys. In IgA nephropathy, abnormal IgA-containing immune deposits can trigger inflammation within these filters.

Over time, this inflammation may result in:

• Blood in the urine
• Protein leakage into the urine
• High blood pressure
• Reduced kidney function
• Chronic kidney disease in some patients

The condition is sometimes called Berger disease.

What are the symptoms of IgA nephropathy?

Some patients discover the condition during a routine urine examination.

Possible signs include:

• Blood in the urine
• Dark or tea-colored urine
• Foamy urine
• Protein detected during urine testing
• Swelling around the ankles or legs
• High blood pressure
• Fatigue
• Reduced kidney function

Blood in the urine can sometimes become noticeable during or shortly after a respiratory infection.

However, visible blood in urine can have many different causes and should always be medically evaluated.

How is IgA nephropathy diagnosed?

A nephrologist may begin with blood and urine tests to evaluate kidney function and protein loss.

Investigations can include:

• Serum creatinine
• eGFR
• Urine routine examination
• Urine albumin or protein measurement
• Blood pressure assessment
• Additional blood tests to rule out other diseases
• Kidney ultrasound when indicated

In selected patients, a kidney biopsy may be recommended.

A biopsy can provide information about the type and severity of kidney injury and help guide treatment decisions.

What determines IgA nephropathy treatment?

Treatment is not identical for every patient.

A nephrologist may consider:

• Amount of protein in the urine
• eGFR and kidney function
• Blood pressure
• Rate of kidney function decline
• Findings from kidney biopsy when performed
• Presence of swelling
• Other medical conditions
• Overall risk of progression

This risk-based approach helps avoid unnecessary treatment while identifying patients who may benefit from more intensive therapy.

Medicines used in IgA nephropathy treatment

Depending on the patient's risk profile, treatment may include medicines aimed at protecting kidney function and reducing complications.

Medicines for blood pressure and proteinuria

Certain kidney-protective medicines can lower blood pressure and reduce protein leakage into the urine.

Reducing persistent proteinuria is an important goal because significant protein loss can be associated with increased risk of kidney disease progression.

SGLT2 inhibitors

For some patients with chronic kidney disease, an SGLT2 inhibitor may be considered as part of kidney-protective treatment.

Whether these medicines are appropriate depends on kidney function, other health conditions and the overall treatment plan.

Other targeted treatments

Selected patients with higher-risk IgA nephropathy may be considered for more specific therapies that target the immune or inflammatory mechanisms involved in the disease.

These treatments are not appropriate for everyone and require specialist assessment.

Steroids or immunosuppressive therapy

In certain patients with significant risk of progression, immunosuppressive treatment may be considered.

Because these medicines can have important side effects, the potential benefits and risks need to be carefully assessed before treatment.

Patients should never begin steroid or immunosuppressive treatment without specialist supervision.

IgA nephropathy and blood pressure control

High blood pressure can place additional stress on the kidneys.

Maintaining blood pressure within the target recommended by the treating doctor can therefore be an important component of IgA nephropathy management.

Regular home monitoring may be recommended for some patients.

IgA nephropathy diet

There is no single diet that cures IgA nephropathy.

Dietary recommendations are usually based on kidney function and individual laboratory results.

A nephrologist or renal dietitian may recommend:

• Limiting excessive salt
• Maintaining appropriate protein intake
• Managing body weight
• Choosing minimally processed foods
• Adjusting potassium or phosphorus only when medically indicated

Patients should avoid extreme elimination diets without professional guidance.

Can IgA nephropathy be cured?

There is currently no guaranteed treatment that permanently eliminates IgA nephropathy in every patient.

However, appropriate management can help control risk factors and, in suitable patients, slow the progression of kidney disease.

The long term outlook varies significantly. Some patients maintain stable kidney function for many years, whereas others develop progressive chronic kidney disease.

Regular monitoring is therefore important even when symptoms are minimal.

Monitoring kidney function during treatment

Patients with IgA nephropathy may need periodic monitoring of:

• Serum creatinine
• eGFR
• Urine protein or albumin
• Blood pressure
• Potassium
• Other blood parameters depending on treatment

A change in urine protein or eGFR over time can help the nephrologist assess the response to treatment and determine whether the management plan needs modification.

Can IgA nephropathy lead to kidney failure?

In some patients, IgA nephropathy can progressively damage the kidneys and eventually result in advanced chronic kidney disease or kidney failure.

The risk is not the same for everyone.

Persistent significant proteinuria, uncontrolled blood pressure, reduced kidney function and certain biopsy findings may indicate a higher risk of progression.

Early recognition and appropriate nephrology follow up can help with risk assessment and management.

What happens if kidney function becomes severely reduced?

If IgA nephropathy progresses to advanced kidney failure, kidney replacement therapy may eventually become necessary.

Treatment options can include:

• Hemodialysis
• Peritoneal dialysis
• Kidney transplantation
• Conservative kidney management for selected patients

The appropriate option depends on the patient's overall medical condition and personal circumstances.

Lifestyle habits that may support kidney health

Alongside medical treatment, patients may be advised to:

• Avoid smoking
• Maintain a healthy body weight
• Follow an appropriate physical activity routine
• Limit excessive salt
• Take prescribed medicines consistently
• Monitor blood pressure
• Attend regular kidney checkups
• Avoid unnecessary painkillers
• Inform doctors about all medicines and supplements being used

Lifestyle measures should complement, not replace, prescribed medical treatment.

When should you see a nephrologist?

Specialist evaluation is particularly important if you have:

• Persistent protein in urine
• Repeated blood in urine
• Unexplained swelling
• High blood pressure with abnormal kidney tests
• Declining eGFR
• Elevated creatinine
• A previous kidney biopsy showing IgA nephropathy

Early specialist assessment can help determine the severity of the disease and establish an appropriate monitoring plan.

Specialized IgA nephropathy care at Prabhakar Bhurke Clinic

Dr. Sandip Prabhakar Bhurke provides specialized nephrology care for patients with IgA nephropathy and other glomerular kidney diseases.

Evaluation and treatment may include:

• Detailed kidney function assessment
• Proteinuria evaluation
• Blood pressure management
• Review of kidney biopsy findings
• Medication planning
• Monitoring for CKD progression
• Management of advanced kidney disease
• Dialysis planning when appropriate
• Kidney transplant evaluation when required

Treatment is tailored according to the patient's kidney function, laboratory findings, risk profile and overall health.

Take IgA nephropathy seriously even when symptoms are mild

IgA nephropathy can sometimes remain unnoticed because kidney damage may initially produce few symptoms. Regular urine and blood testing can help identify changes before significant kidney function loss occurs.

If you have been diagnosed with IgA nephropathy, consistent nephrology follow up can help monitor proteinuria, blood pressure and kidney function and determine whether your treatment needs to change over time.

Medical Disclaimer

This article is intended for general educational and informational purposes only and does not constitute medical advice, diagnosis or treatment. IgA nephropathy can vary substantially between patients, and the appropriate treatment depends on kidney function, proteinuria, blood pressure, biopsy findings, other medical conditions and individual risk factors. Medicines such as steroids, immunosuppressive therapies and other kidney treatments should only be used under appropriate medical supervision. Do not start, stop or change medicines or dietary restrictions based on this article. Consult Dr. Sandip Prabhakar Bhurke or another qualified nephrologist for an individualized diagnosis and IgA nephropathy treatment plan.