How To Treat IgA Nephropathy (Berger's Disease)

Immunoglobulin A nephropathy (known as IgA nephropathy or Berger's disease) is a rare kidney disease that occurs when the body's immune system response causes IgA antibodies to build up in the kidneys.

Researchers are still learning more about this condition and developing new treatments, but medications, procedures, and lifestyle changes can help. While there's no cure at this time, treatment relieves symptoms, slows kidney damage, and prevents kidney failure.

Medications

IgA nephropathy is a kidney disease, so treatment for it focuses on managing symptoms and slowing down or preventing kidney damage. Medications are a primary treatment option for this condition, as they can help:

• Reduce inflammation 
• Control blood pressure 
• Remove extra fluid from the body
• Lower cholesterol levels

Your healthcare provider may recommend one or more of the following medications:

• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs): Control hypertension (high blood pressure) and slow down kidney damage by reducing the amount of protein that passes into the urine through damaged kidneys
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors: Lower blood sugar levels and the amount of protein in the urine, which may be particularly useful for people living with both IgA nephropathy and diabetes
• Corticosteroids: Reduce inflammation by suppressing an overactive immune system and signaling it to produce fewer IgA antibodies
• Statins: Help lower low-density lipoprotein (LDL) cholesterol, which some people with IgA nephropathy may need to do to reduce the risk of developing heart disease

The U.S. Food and Drug Administration (FDA) has also recently approved some newer medications to more directly target IgA nephropathy, with others still being studied in clinical trials.

So far, this includes Tarpeyo (budesonide), a corticosteroid, and Filspari (sparsentan), a type of medication known as an endothelin and angiotensin II receptor antagonist. Both work to lower protein levels in the urine of adults who are at risk of experiencing rapidly progressing IgA nephropathy.

Surgeries and Procedures

If Berger's disease worsens and causes kidney failure, there are a few additional treatment options that your provider can use to help reduce symptoms. These include:

• Dialysis: This procedure uses a filtering machine to manually remove toxins and extra fluid from the blood when the kidneys can no longer effectively perform that function. It can be done at a medical center or at home and is usually needed several times per week.
• Kidney transplant: A donated healthy kidney replaces a diseased kidney during this surgical procedure. The surgery is performed under general anesthesia. It involves the surgeon making an incision in the lower part of the stomach and inserting the new kidney. Once the organ is connected to the artery and vein in your pelvic area, your blood will start flowing through the new kidney as it produces urine.
  

Complementary and Alternative Medicine

There are also a few treatment options your healthcare provider may recommend that fall under the complementary and alternative medicine (CAM) category. However, you should use CAM therapies in conjunction with your medications and not as a replacement.

Fish Oil

Certain studies have shown that taking fish oil as a supplementary treatment for IgA nephropathy may offer some benefits.

Researchers believe that omega-3 fatty acids in fish oil act as anti-inflammatories and may be an alternative to other immunosuppressants such as corticosteroids, but without the unwanted side effects. Findings suggest the omega-3 fatty acids in fish oil could support lower blood pressure and help slow disease progression. However, more research is still needed to confirm these benefits.

Tonsillectomy

Some research has indicated that getting a tonsillectomy—even if you don't have currently inflamed or infected tonsils—may be beneficial for people with progressive Berger's disease, particularly when used in combination with corticosteroid treatment.

Studies have shown a link between chronic tonsillitis (when glands in the back of your throat become infected) and the development of IgA nephropathy. Experts think there seems to be a connection between the tonsils' bacterial environment and the immune system response involved in IgA nephropathy.

Although some findings suggest that tonsil removal appears to be effective in improving the progression of Berger's disease, additional data is needed before this procedure can be broadly recommended.

Probiotics

Other emerging evidence points to targeting the gut mucosal immune system—an internal network that helps protect the body from infection—to help treat chronic kidney diseases like IgA nephropathy.

Research suggests that people with IgA nephropathy often experience gut dysbiosis, an imbalance of healthy bacteria in the gut. Some experts think treating the gut's bacterial environment with probiotics, for example, may help improve this balance and support a healthy immune system response.

Recent findings suggest that probiotics might be helpful for improving IgA nephropathy symptoms and quality of life, reducing inflammation, and delaying disease progression. However, more, larger-scale studies are required to solidify this treatment tactic.

Lifestyle Changes

There are several lifestyle adjustments that your healthcare provider may suggest to help support your treatment plan. This typically includes recommendations such as the following:

• Eat a nutritious diet: Includes foods low in sodium, saturated fat, and cholesterol to reduce swelling and lower blood pressure
• Drink more fluids: Controls any additional swelling
• Exercise regularly: Helps maintain a weight that's right for your body
• Avoid smoking: Prevents disease progression, improves inflammation, and reduces kidney failure risk

Prognosis and Life Expectancy

Although there isn't a cure for IgA nephropathy yet, available treatment options can help prevent or delay damage to your kidneys, slowing the progression of the condition. Additionally, new treatments for IgA nephropathy are being developed and studied in clinical trials.

In many cases, IgA nephropathy does not worsen over time. Instead, it improves or stays stable with treatment. Some data suggests that up to 50% of people with this condition experience a benign (mild or slowly progressing) journey.

It's also considered rare for Berger's disease to progress quickly. Around 1 in 5 people with IgA nephropathy will develop kidney failure within 10 years of being diagnosed. In these cases, a kidney transplant or dialysis may be needed. However, your condition can become more severe if you have untreated high blood pressure or large amounts of protein in your urine.

Living With and Managing IgA Nephropathy

Many people who have Berger's disease can live a healthy life. Receiving a diagnosis for any condition can be scary, but medical experts recommend these tips to help you process your condition and learn to live well with it:

• Stay active through exercise and physical movement most days of the week, if possible
• Maintain a regular sleep schedule and get at least seven to eight hours of quality slumber per night
• Engage in hobbies as a way to reduce stress and promote joy
• Connect with a therapist, if needed, to navigate changes in mental health related to chronic disease management

You may also be interested in learning more about current IgA nephropathy research studies and clinical trials. The KidneyCARE (Community Access to Research Equity)™ Study is a patient registry offering information, updates, and educational materials in English and Spanish.

Keep in mind: If you've been diagnosed with IgA nephropathy, know that you're not alone. It's estimated that around one in 10 kidney biopsies in the United States show a Berger's disease diagnosis.

Keeping in contact with others living with the same condition can offer moral support. To connect with support groups and community-based resources near you, consider checking out the IgA Nephropathy Foundation and the National Organization for Rare Disease (NORD).