Medicines for IgA nephropathy

What it is

IgA nephropathy (Berger's disease) is one of the most common conditions affecting the kidneys' tiny filters (a type of glomerulonephritis). It occurs when an antibody called immunoglobulin A (IgA) builds up in the glomeruli (the kidney filters), causing inflammation that can, over time, affect how well the kidneys work. A characteristic feature is visible blood in the urine that often appears during or soon after an infection (such as a cold or sore throat), sometimes making the urine dark or cola-coloured; between these episodes, there may be invisible blood and/or protein in the urine found on testing. Many people also have no obvious symptoms and are diagnosed after blood or protein is found in the urine on a routine test. IgA nephropathy varies greatly: in many people it is mild and progresses slowly or not at all, while in others it can, over years, lead to a gradual decline in kidney function and, in some, to chronic kidney disease. It is more common in younger adults. Because it can affect the kidneys over the long term, it is monitored and managed to protect kidney function.

How it is treated

IgA nephropathy is diagnosed and managed by a kidney specialist (nephrologist). The diagnosis is usually confirmed by a kidney biopsy (a small sample of kidney tissue), which shows the IgA deposits, alongside urine and blood tests and blood pressure checks. Because it varies so much, management is tailored to how active the condition is and the risk to the kidneys. For many people, the focus is on protecting the kidneys and slowing any progression, rather than a specific "cure": this includes controlling blood pressure well (certain blood pressure medicines both lower blood pressure and reduce protein leakage and protect the kidneys), reducing protein in the urine, and general kidney-protective measures (such as not smoking, a healthy diet with advice on salt, and managing cardiovascular risk). Regular monitoring of kidney function, urine protein and blood pressure tracks the condition over time. For people with more active disease or a higher risk of progression, additional treatments — including medicines that reduce immune activity (such as steroids) or newer targeted therapies — may be considered by the specialist. The reassuring message is that IgA nephropathy is often mild or slowly progressive, is one of the most common and well-understood kidney filter conditions, and that monitoring and treatment (particularly controlling blood pressure and protein) can protect kidney function over the long term.