Signs and Symptoms of IgA Nephropathy

IgA nephropathy (also known as IgAN or Berger’s disease) is an autoimmune disorder that occurs when the immune system mistakenly attacks glomeruli—tiny blood vessels in the kidneys that filter blood. This leaves deposits of an antibody called immunoglobin A (IgA) in the kidneys, which can cause symptoms like dark-colored urine, swelling, and an uptick in respiratory infections. If left untreated, IgAN can lead to kidney failure.

It's worth noting that this disease is a chronic (long-term) but slow-moving condition. Many people don't experience symptoms for several years, and oftentimes, an infection triggers symptoms to develop. Treatment can help prevent the disease from progressing. However, about 30% to 40% of those with IgA nephropathy develop kidney failure 20 to 30 years after symptom onset.

Early Symptoms 

The kidneys filter out your blood and release the waste and toxins through your urine. This filtering occurs in the glomeruli, tiny blood vessels found in kidney structures called “nephrons.” IgA nephropathy causes inflammation and damage in these blood vessels. As a result, blood leaks into the urine.

This can cause some early symptoms, such as:

• Frequent respiratory infections: Infections like the cold can cause symptoms such as a sore throat, cough, and nasal congestion in the early stages of IgAN
• Dark-colored urine: Pink, caramel, brown, or “Coca-Cola” colored urine is a hallmark symptom of this condition
• Severe hypertension: Very high blood pressure is another sign of IgA nephropathy, which usually doesn't cause any symptoms but can raise the risk of other conditions like heart disease or heart attack

Progressive Symptoms 

Additional symptoms may develop as IgA nephropathy progresses. These often occur due to progressive damage to the nephrons and glomeruli in the kidneys. Progressive symptoms of IgA nephropathy include:

• Foamy or cloudy urine (pee): Damage to the blood vessels can cause proteinuria (excess protein in the urine), which can give urine a foamy appearance.
• Edema (swelling): When fluid is trapped or retained in your body, you may experience swelling in the feet, ankles, legs, and hands.
• Bleeding and bruising: The damage to the kidney can lead to thrombocytopenia, which occurs when your blood has insufficient platelets that your body needs to use for blood clotting. This can cause easy bruising and can make it difficult to stop bleeding when you injure yourself.
• Pain in the sides: Damage to the kidneys can also cause pain. You might feel discomfort on one or both sides of your back.
• Fatigue and weakness: Exhaustion and muscle weakness are common with IgAN, especially as the condition progresses.
• Gastrointestinal symptoms: In about 35% of cases, IgA nephropathy causes digestive symptoms such as diarrhea (loose and watery stools), cramping, and abdominal pain. 

End-Stage Symptoms 

Over time, IgA nephropathy can significantly damage the kidneys and increase the risk of end-stage kidney disease or kidney failure. With proper treatment, though, most people won't reach a late stage of IgAN—especially if the condition is caught early.

However, up to 30% of people with this condition may develop kidney failure several years or decades after their diagnosis, especially if they don't receive proper treatment.

If you have late-stage IgAN, you may experience additional symptoms, such as:

• Headaches
• Itchiness and skin rashes
• Insomnia
• Nausea and vomiting
• Loss of appetite and sense of smell or taste
• Inability to urinate
• Unexpected weight loss
  
• Bone or joint pain
• Foul-smelling breath
• Excessive thirst
• Changes in menstrual patterns or sexual function
• Cognitive changes, such as confusion or memory problems

When to Contact a Healthcare Provider 

You should call your healthcare provider if you have any early warning signs because IgA nephropathy can damage the kidneys and lead to serious complications. Getting a diagnosis in the early stages can significantly increase your prognosis and quality of life.

You should seek prompt medical attention if you have symptoms such as blood in the urine, swelling, and difficulty peeing.

Severe kidney damage and complications from IgA nephropathy (such as heart problems) are a medical emergency. If you or a loved one experience any of these symptoms, call 911 or head to the nearest emergency department as soon as possible:

• Seizures
• Loss of consciousness
• Breathing difficulties
• Chest pain

A Quick Review 

IgA nephropathy is a progressive autoimmune disease that affects the kidneys and can cause kidney failure if left untreated. In the early stages, common symptoms include foamy or dark-colored urine and frequent infections.

As the condition progresses, you may experience swelling, easy bruising, fatigue, and weakness. Many people with IgAN never reach end-stage kidney disease. Symptoms during late-stage IgAN include sleep problems, difficulty with memory, loss of appetite, and trouble urinating.

Keep in mind: IgAN can cause serious complications, so treatment is necessary to improve symptoms and quality of life. The choice of treatment is based on a number of different factors including blood pressure, estimated kidney function, and the amount of protein in the urine.

If you or a loved one may have symptoms of this condition, please seek attention from your healthcare provider to reduce the risk of complications.