Diagnosis

IgA nephropathy is often found after you notice blood in your urine. Or a routine test might show that you have protein or blood in your urine. You'll need other exams too. They may include:

  • Urine tests. A lab can check a sample of your urine under a microscope. This is done to find out how well your kidneys are working and how much protein the kidneys are spilling. With IgA nephropathy, the lab exam shows blood in the urine or other signs that could hint at inflammation of the tiny filters in the kidneys, called glomeruli.
  • Blood tests. If you have kidney disease, blood tests might show higher levels of the waste product creatinine or the protein cystatin C.
  • Kidney biopsy. This procedure is the only way to confirm whether you have IgA nephropathy. A special needle is used to take out small pieces of kidney tissue. Then the tissue is checked under a microscope.
  • Iothalamate clearance test. Your doctor also may recommend this test. It uses a special contrast agent to track how well your kidneys are filtering wastes.

Treatment

There's no cure for IgA nephropathy. There's also no sure way to predict how much the disease will affect your health over time. Some people need only medical tests to track whether the disease is getting worse.

For others, medicines can slow the disease from becoming worse and help manage symptoms.

Medicines to treat IgA nephropathy include:

  • High blood pressure drugs. Medicines called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can lower blood pressure and reduce how much protein the body loses.
  • Medicines that calm the immune system. These also are called immunosuppressants. They include corticosteroids and other strong medicines that can lessen the body's defenses. They might keep the immune system from making the proteins that attack the glomeruli. These medicines can cause serious side effects, such as high blood pressure, high blood sugar and a greater risk of infection. Your doctor helps you choose an immunosuppressant medicine. Many new treatments have been approved or are being tested in clinical trials. Talk with your doctor about the latest advances in the treatment of IgA nephropathy.
  • Omega-3 fatty acids. These healthy fats might curb inflammation in the glomeruli without harmful side effects. You can get omega-3s from fish oil supplements. But don't buy those off the shelf. Ask your doctor if prescription fish oil supplements might help you.
  • Cholesterol medicine. If you have high cholesterol, this type of medicine can help control it and slow down kidney damage.
  • Diuretics. These can help control swelling in the hands and feet called edema.

The main goal of treatment is to keep you from needing dialysis or a kidney transplant. But either of those treatments can be lifesaving if your kidneys stop working well enough on their own.

Lifestyle and home remedies

To help keep your kidneys healthier:

  • Take steps to lower your blood pressure. This can help slow kidney damage from IgA nephropathy. Start with some healthy lifestyle changes. Limit how much sodium and fat you eat. Lose any extra weight. Get regular exercise. And if you drink alcohol, do so in moderation. Also take your blood pressure medicines as prescribed.
  • Keep track of your blood pressure at home. If your health care team asks you to do this, write down each blood pressure reading. Then bring the record with you to checkups.
  • Eat less protein. Ask your doctor if you should cut back on protein. This may help slow IgA nephropathy from becoming worse and protect your kidneys.

Coping and support

Coping with severe forms of IgA nephropathy can be a challenge. But you don't have to do it alone. If you have questions or you need guidance, talk with a member of your health care team.

It also might help to join a support group. You can meet other people who may understand what you're going through and share information with you. To find out about support groups in your area that deal with kidney disease, ask your health care team. Or contact the National Kidney Foundation (NKF) to learn about NKF Peers, a national, telephone-based peer support program. Call 855-NKF-PEER (855-653-7337) to join.

Preparing for your appointment

You're likely to start by seeing your primary doctor. But you might be referred to a doctor who is trained to treat kidney disorders, called a nephrologist. Here are some tips to get ready for your appointment.

What you can do

Ask your doctor's office if you need to fast for a blood test or follow any other restrictions.

Make a list of:

  • Your symptoms and when they began. Include any symptoms that don't seem related to the reason for your appointment.
  • All medicines you take. Include medicines you buy without a prescription, vitamins, herbs or other supplements. Note how much medicine you take, called the dose.
  • Questions to ask your doctor. This way you can make the most of your time together.

Ask a family member or friend to go with you to help you remember the information you receive.

Questions to ask your doctor include:

  • What tests do I need?
  • What's the best course of action? How long will I need medicines?
  • Can I manage this disease with diet and lifestyle changes?
  • I have other health conditions. How can I best manage these conditions together?
  • Do you have printed materials on this condition that I can have? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you questions such as:

  • Do your symptoms happen often or just once in a while?
  • How bad are your symptoms?
  • Does anything seem to make them better?
  • What, if anything, seems to make them worse?
By Mayo Clinic Staff