7 Things You Didn't Know About IgA Nephropathy

These 7 "take-home" points will help you understand this common kidney disorder

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IgA Nephropathy is one of the most common kidney diseases worldwide

While the average person on the street might not have heard about this, IgA Nephropathy is a common disease that most kidney doctors will see pretty regularly among their patients. Therefore, it should be a common consideration when seeing patients presenting with kidney problems like blood or protein in the urine (after the other usual suspects, diabetes or high blood pressure-related kidney diseases).Typically, more men are affected than women.

IgA Nephropathy has a very characteristic age, and geographic distribution

For reasons we don't clearly understand, IgA Nephropathy seems to be more common in the regions around the Pacific Rim and in Southern Europe.  It is not as common in Northern Europe or North America. And again for reasons that we don't quite understand, it tends to occur more in the second and third decade of life.

Your body's defence mechanism turns against you

As the name suggests, IgA Nephropathy (or kidney disease because of IgA) occurs when a protein called IgA (which the body typically makes to fight infections) settles in the kidney and incites an inflammatory reaction.  This process could occur over a period of weeks to years.  What triggers this is not clearly understood. You, therefore, come under "friendly fire". 

You may not know about it

IgA Nephropathy will typically cause you to leak blood in the urine; however you may or may not see it.

The fact might remain unknown for years, decades perhaps, especially if the amount of blood being lost in the urine is very small. Even if the blood is discovered on a urine test, it is sometimes erroneously attributed to a urinary tract infection. Discovery of blood in the urine in the absence of infection should always raise the question of IgA Nephropathy.

A very characteristic finding is the appearance of blood in the urine during episodes of other infections (like a sore throat).
Loss of blood in the urine is not the only feature however. Protein can also be present in the urine in varying amounts.

Diagnosis cannot be confirmed without a kidney biopsy

As mentioned above, the clinically apparent features of IgA Nephropathy can be very variable and the disease can remain silent for years. If a physician is suspecting that you might have IgA nephropathy, typically he would refer you to a specialist, called a nephrologist.  After the initial evaluation, the nephrologist will typically order a biopsy of your kidney.  The details of this procedure are mentioned here.

We still don't understand what triggers IgA Nephropathy

Over the last few decades, many studies have tried to address this question.  The potential culprits range from medications, to autoimmune diseases, to cancers, and finally infections.  The specific geographic distribution of the disease as well as its propensity to occur in certain age groups has raised the question if a specific environmental trigger might be present.

 However, at this point of time we have not been able to identify that.

IgA Nephropathy can have very varying outcomes

The disease course of IgA Nephropathy is not always predictable.  However, there are certain tests that can be done to come up with a semblance of a prognosis.  Typically, patients whose creatinine is elevated, or who run a high blood pressure, or those who leak a lot of protein in the urine are considered higher risk for progression to kidney failure.  

In the best case scenario, IgA Nephropathy will often go undiagnosed and the person affected will lead a full normal life.  In the worst case scenario, complete kidney failure can occur over a matter of months to years necessitating dialysis or a kidney transplant.  Overall as a percentage, about 1 in 4 adults with IgA Nephropathy will develop complete kidney failure within 20-25 years of initial diagnosis.

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