IgA Nephropathy Causes , Symptoms, Complications, Diagnosis, Treatment, Prevention, Diet

IgA Nephropathy Causes , Symptoms, Complications, Diagnosis, Treatment, Prevention, Diet

Definition of IgA Nephropathy

IgA nephropathy (nuh-FROP-uh-thee), also known as Berger's disease, is a kidney disease that occurs when an antibody called immunoglobulin A (IgA) lodges in your kidneys. This results in local inflammation that, over time, may hamper your kidneys' ability to filter waste, excess water and electrolytes from your blood. Kidney damage may be indicated by blood and protein in your urine, high blood pressure and swollen feet.

IgA Nephropathy Causes , Symptoms, Complications, Diagnosis, Treatment, Prevention, Diet
IgA Nephropathy

IgA nephropathy usually progresses slowly over many years, but the course of the disease in each person is uncertain. Some people leak blood in their urine without developing problems, some eventually achieve complete remission, and others develop end-stage kidney failure.

No cure exists for IgA nephropathy, but certain medications can slow its course. Keeping your blood pressure under control and reducing your cholesterol levels also slow disease progression.

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Causes of IgA Nephropathy

Your kidneys are two bean-shaped, fist-sized organs located at the small of your back, one on each side of your spine. Each kidney contains tiny blood vessels (glomeruli) that filter waste, excess water and other substances from your blood as they pass through your kidneys. The filtered blood re-enters your bloodstream, while the waste material passes into your bladder and out of your body when you urinate.

Immunoglobulin A (IgA) is an antibody that plays a key role in your immune system by attacking invading pathogens and fighting infections. But in IgA nephropathy, this antibody collects in the glomeruli, causing inflammation (glomerulonephritis) and gradually affecting their filtering ability.

Researchers don't know exactly what causes IgA deposits in the kidneys, but these conditions or factors may be associated with the development of IgA nephropathy:

  • Genes, because IgA nephropathy is more common in some families and in certain ethnic groups

  • Liver diseases, including cirrhosis, a condition in which scar tissue replaces normal tissue within the liver, and chronic hepatitis B and C infections

  • Celiac disease, a digestive condition triggered by eating gluten, a protein found in most grains

  • Dermatitis herpetiformis, an itchy, blistering skin disease that stems from gluten intolerance

  • Infections, including HIV infection and some bacterial infections

Risk factors of IgA Nephropathy

Although the exact cause of IgA nephropathy is unknown, these factors may increase your risk of developing this condition:

  • Your sex. In North America and western Europe, IgA nephropathy affects at least twice as many men as it does women.
  • Ethnicity. IgA nephropathy is more common in Caucasians and Asians than it is in blacks.
  • Family history. In some cases, IgA nephropathy appears to run in families, indicating that genetic factors may contribute to the disease.

Symptoms and Complications of IgA Nephropathy

The kidneys play three major roles in regulating the body:

They filter urine to remove wastes from the body, keeping toxins from building up in the bloodstream.
They regulate the minerals or electrolytes (sodium, calcium, and potassium, for example) and the levels of fluid in the body.

They produce hormones that control other body functions such as blood pressure, bone maintenance, and the production of red blood cells.

A common symptom of IgA nephropathy is dark or bloody urine, especially following a bout of physical stress such as a cold.

IgA nephropathy is not always a progressive illness

In many cases, people with IgA nephropathy remain stable, do not develop kidney failure, and are able to have their symptoms treated effectively.

Doctors have found that about 25% of those with IgA nephropathy develop chronic kidney failure that progresses to end-stage kidney failure.

Symptoms of end-stage kidney failure include:

  • confusion
  • decreased urination
  • fatigue
  • headache
  • high blood pressure
  • itchy skin
  • loss of appetite
  • muscle twitching or cramping
  • nausea and vomiting
  • nosebleeds
  • puffy eyes, hands, and feet (called edema)
  • shortness of breath
  • thirst
  • weight loss
  • a yellowish-brown tint to the skin

Diagnosing IgA Nephropathy

If IgA nephropathy is suspected, the doctor takes a thorough patient history, paying attention to any past infections or kidney problems. The doctor will do a physical exam, checking blood pressure and looking for some of the physical symptoms of kidney failure.

Urine and blood tests will be ordered. The urine is checked for elements that shouldn't be there, such as protein or red blood cells, while blood tests show if there's a buildup of body wastes in the bloodstream.

A definite diagnosis can only be made by a kidney biopsy. To do a biopsy, they insert a fine needle into the kidney, using ultrasound as a guide. With the needle, they take a tiny tissue sample, and then they check it under a microscope for protein deposits.

In rare cases, doctors may decide that an open biopsy is necessary. This procedure is performed by a surgeon, who makes an incision to view the kidney and any abnormalities.

Treating and Preventing IgA Nephropathy

There is no specific treatment for IgA nephropathy. The goal is to reduce symptoms caused by the kidney's inability to work properly, and to try to avoid the problems this can cause, such as chronic renal failure.

The health care team may suggest dietary changes to reduce the amount of salt and protein intake. A registered dietitian can help draw up a healthy eating plan that takes this into account. Fish oils may be added to the diet. Corticosteroids and medications to suppress the immune system may also be used.

Hypertension (high blood pressure) may have been a warning sign of IgA nephropathy. If this is the case, it will be treated, usually with antihypertensive medications (medications for high blood pressure). Hypertension is also a complication of most kidney disorders. If blood pressure isn't already high when a person is diagnosed with IgA nephropathy, doctors will watch closely for its development. Lifestyle changes (e.g., diet, exercise, stress management) to help avoid getting high blood pressure might be recommended.

If kidney damage gets worse, chronic kidney failure may set in. In these cases, kidney dialysis is necessary. Dialysis uses a membrane, instead of a kidney, to remove excess fluids and waste from the body.

Dialysis is not a cure, and people who are on dialysis must still follow special diets, restrict fluids, and take medications as prescribed by their doctors. The type of dialysis performed - peritoneal dialysis or hemodialysis - is chosen by the health care team according to the needs of the individual patient.

Peritoneal dialysis uses the natural membrane in the abdominal cavity, called the peritoneum, as its filter. Using a catheter (a very small, flexible tube) that's been permanently placed into the abdomen, the abdominal cavity is filled with a solution called dialysate, which stays there for a set amount of time. The dialysate then draws the waste and extra fluid out of the bloodstream through the membrane. When finished, the dialysate - now with the extra body fluid and waste mixed in - is drained out and then replaced with fresh dialysate.

This procedure is usually done at home, by the individual or by a family member. It is continuous and done in cycles. The cycles can take place as frequently as every 6 hours or, in some cases, only once a day (i.e., put in the dialysate at night and drain it in the morning). The procedure is done daily, but how often during the day varies according to the type of peritoneal dialysis.

Peritoneal dialysis doesn't work for everyone and may eventually stop working effectively for those who do use it. If this happens, hemodialysis is necessary.

Hemodialysis is a procedure that is usually done in a hospital or special clinic setting. In this process, the waste and excess body fluid are filtered out through the blood using a machine called a dialyser. The person's blood is pumped into the machine and stays on one side of the membrane, while the dialysate is on the other side of the membrane. As with the peritoneal dialysis, the dialysate draws the extra body fluid and waste through the filter and then the filtered blood is pumped back into the body. The process of hemodialysis is quicker than peritoneal dialysis, and the cycle is generally finished in about 4 hours. It's usually done about 3 times a week.

All those who require dialysis are assessed for a kidney transplant. As frightening as this may sound, kidney transplants are now quite common and have a good success rate. Someone who has had a successful transplant can go on to live a healthy life. Kidneys can be donated by a live donor (e.g., a relative) or by someone who has died and left his or her organs for donation.

It's entirely possible to live a full, healthy life with only one kidney - one fully functioning kidney can do the work of two - but it's essential to watch for signs of any problems with the remaining kidney.

Currently, there isn't any known way to prevent IgA nephropathy. That said, by being aware of the signs and symptoms of kidney disease, it's sometimes possible to delay its progression to kidney failure.

Lifestyle and home remedies

Take steps to reduce your blood pressure. Keeping your blood pressure levels near normal may help slow kidney damage from IgA nephropathy. Your doctor may recommend healthy changes in your diet — including limiting your salt intake — losing excess weight, being physically active, using alcohol in moderation and remembering to take your blood pressure medications as ways to keep your blood pressure under control.

Monitor your blood pressure levels at home. Note each reading and bring this record with you to your doctor's appointments.

Eat less protein. Reducing the amount of protein you eat and taking steps to decrease your cholesterol levels may help slow the progression of IgA nephropathy and protect your kidneys.

The diet for patients with IgA nephropathy

IgA nephropathy is one kind of common kidney disease, more and more patients suffer from this disease. A good treatment can help them fight with disease; good diet also can give patients a hand. Let’s learn something about the diet for patients with IgA nephropathy.

1. Bland food is good for patients with IgA nephropathy. But patients should avoid sea food, beef, mutton, and spicy food, quit smoke and drink.

2. Fresh vegetable and fruit is good for patients with IgA nephropathy, drink proper water. Never eat any tonic,chili, lychee, chocolate and other food which make patients body unbalance.

3. IgA nephropathy patients with severe swelling should avoid salt intake, meanwhile, limit water and protein food. If patients no swelling, they needn’t limit water and protein food intake. Patients with microscopic hematuria should intake more water, apple, white sugger, semen sesame nigrum, agaric and other food.

4. For IgA nephropathy patients with hyperkalemia should avoid high potassium food, such as bananas, citrus, potatoes, tomatoes, squash, tea, soy sauce, monosodium glutamate. For patients with hypokalemia should eat more high potassium food.

5. For IgA nephropathy patients with high blood uric acid should avoid animal giblets, fish, shrimp, crab, clam, beer, mushroom, beans, spinach and so on.