Immunoglobulin A nephropathy (IgAN) is a type of kidney disease characterized by a buildup of antibody deposits in the kidneys. These deposits trigger an inflammatory response by the immune system, leading to damage and scar tissue in the kidneys, and a loss of kidney function.
Symptoms of IgAN can include blood and protein in the urine, flank pain (pain on the sides of the lower back), edema (swelling due to fluid buildup), and high blood pressure. IgAN can lead to kidney failure, especially if untreated.
Treatment for IgA nephropathy
There is no cure for IgAN and treatment focuses on slowing disease progression and preventing complications. More specifically, treatment aims to control blood pressure, inflammation, and blood and/or protein in the urine. Improving glomerular filtration rate (the rate at which blood is filtered through the kidneys) is also an important treatment goal.
Medications play a central role in achieving these treatment goals, and a person with IgAN may be treated with several medications, including:
- Medications that help lower and control blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
- Diuretics, medications that help remove excess fluid from the body. These can help relieve edema and also help with controlling blood pressure.
- Corticosteroids, which reduce inflammation and immune system activity to help prevent damage to the kidneys.
- Complement inhibitors, medications that reduce and regulate activity in the complement system (a part of the immune system). Abnormal complement system activity plays a significant role in the development and progression of IgAN.
- Medications to reduce proteinuria (protein in the urine).
- Medications to lower cholesterol.
In addition to medications, changes to diet and lifestyle are an important part of a treatment plan. Dietary changes should be made under the guidance of a registered dietitian, and may include limitations on sodium, protein, and fats, and adopting a more plant-based diet. A person should also avoid tobacco and limit alcohol.
A treatment plan can change over time
Treatment needs can change over time, which means the medications a person takes can change over time. Treatment options are also evolving—and you and your healthcare provider may discuss adding or switching treatments if there is a newer therapy available that meets your needs. It’s worth talking to a healthcare provider about newer treatment options.
If you or a loved one is living with IgA nephropathy, it’s important to understand the medications you are taking, why each medication is needed, and how to take each medication.
What to ask when prescribed a new medication
- What is the name of the medication?
- Why is this medication recommended? What is the goal of taking this medication?
- What dosage will I be taking?
- How is this medication administered? How often will I need to take this medication and at what times of day?
- How will we know if this medication is working? What can I do to improve my chances of this medication working?
- Is there anything that I need to avoid while taking this medication? Can this medication interact with other medications?
- Is there a risk of side effects? Is there any risk of severe side effects? What symptoms or side effects do I need to watch for? How can side effects be avoided and/or addressed?
- What will this medication cost? Ask what you can do and who you can talk to if you have concerns about the cost of a medication.
While the focus here is on medications for IgAN, these questions can apply to medications for other conditions as well. IgAN can and does occur alongside other health conditions that require treatment with medications, including autoimmune disorders, liver disease, chronic infections, and numerous others.
Each of your healthcare providers should have an up-to-date list of medications you are taking, including prescription medications, over-the-counter medications, and supplements (including herbal supplements).
Working with your healthcare team
IgAN is a different experience for different people. If you or your loved one is living with IgAN, your best source of information will be your healthcare providers.
You are also a valuable source of information for your healthcare providers. Your healthcare providers rely on you to update them about changes in symptoms, concerns you have, challenges you are experiencing, and other aspects of your health, such as other conditions you are managing and medications you are taking.
