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The Kidney Connection - IgA Nephropathy
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IgA nephropathy, also called Berger's disease, was named for the doctor who originally discovered the condition in 1927. It is caused by abnormal deposits of a kind of protein that helps fight infection known as immunoglobulin A (IgA) inside the glomeruli (small blood vessels of the kidneys), resulting in inflammation of the glomeruli. The Process Normally, the glomeruli filter waste and excess water from the blood. This material then passes through small tubes that collect fluid (renal tubules) and eventually end up in the bladder as urine. Unfortunately, the excessive IgA deposits interfere with this process and can lead to protein (proteinuria) and blood in the urine, hypertension, and edema (body swelling, particularly in the hands and feet). IgAN progresses slowly.After about 10-25 years, someone with the condition may show signs of kidney damage. Approximately one-quarter of those with IgAN develop total kidney failure within 25 years. IgAN Symptoms In its early stages, IgAN has no outward symptoms. Later, however, signs and symptoms include: - Gross hematuria (repeated episodes of cola- or tea-colored urine);
- Foamy toilet water;
- Edema;
- Fatigue;
- Nausea;
- Pain in the sides of the body;
- Hypertension;
- Headaches;
- Low-grade fever; and
- Sleep problems.
Rate of Progression More males (particularly young men) than females are affected by the condition, and it may occur at any age. It is more common among Asians and Caucasians and is one of the most common kidney diseases other than diabetes or hypertension. What causes the condition is unknown. There may be an hereditary link, or it could be related to respiratory infections. Nonetheless, there apears to be no consistent "trigger" for the condition. How Is It Diagnosed? IgAN is diagnosed through a urinalysis. If the test is positive, the urine will be examined through a microscope to detect the presence of red blood cells (RBCs). The RBCs may be clumped together in little tubes called casts. This usually means the filters in the kidneys are damaged. Blood tests measure the waste products in the blood that are usually excreted by the kidneys, including creatinine and blood urea nitrogen (BUN). High levels of these products indicate that the kidneys are not working as they should. If the creatinine is high when the diagnosis is made, this usually indicates that the filters in the kidney are damaged. If kidney damage is detected, the doctor will probably perform a kidney biopsy. Only this procedure can show the IgA deposits in the renal filters. The biopsy will also probably indicate how much kidney damage has occurred and can help the doctor determine the best treatment. A Support Network Report In 2004, officials of the IgA Nephropathy Support Network interviewed hundreds of individuals with IgAN and discovered that: - Way too many people have gone for many years through a multitude of urological tests before a correct diagnosis is rendered.
- A diagnosis could be made much earlier if a simple dipstick urinary screening became a part of everyone's physical examination, including children.
- No cure exists.
- Doctors often wait too long, adopting a "wait-and-see-what-happens" attitude before recommending a specific treatment.
Slowing the Progression While there is no cure for the condition, certain medications can help slow down its progression. These include: - Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) to lower blood pressure and reduce the amount of protein in the urine;
- Immunosuppressive and corticosteroid medications; and
- Omega-3 fatty acids, which can be found in fish oil supplements, to reduce inflammation in the glomeruli.
Other ways to help slow the progression of IgAN include: - Keeping control of the blood pressure such as limiting sodium intake to reduce swelling and extra fluid retention;
- Consuming less protein;
- Reducing cholesterol levels; and
- Not smoking.
While coping with IgAN can be challenging, it is important to know that there is help out there. The condition can be discussed with one or more members of your healthcare team. A support group may also help. They can provide useful information along with sympathetic listening. For More Information Last Updated October 2007
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