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What is IgA nephropathy?

IgA nephropathy (IgAN) is a common chronic kidney disease which mainly affects young adults. In IgAN a protein called immunoglobulin A (IgA) becomes trapped in the very fine filters of the kidney (glomeruli), causing damage and scarring to the whole kidney.

IgA is normally present in the bloodstream and its main role is to fight infections throughout the body. But in IgAN the body’s immune cells produce abnormally formed IgA. It is not yet known why this happens.

Around 30 per cent of IgAN patients will go on to lose kidney function and will require a transplant or life on dialysis. There are currently no reliable tests available to predict which of these patients, known as progressors, will lose their kidney function.

IgA nephropathy symptoms

IgAN may be undetected for several years as it commonly does not cause any obvious symptoms. It is usually detected by chance at the time of a blood or urine test or a check of your blood pressure. Common findings are:

  • Blood in your urine (haematuria), which can either be visible to the naked eye or only detectable with a urine test. Visible haematuria often occurs when you have a sore throat, a stomach upset or after exercise.
  • Protein in your urine (proteinuria), detectable through a urine test.
  • High blood pressure (hypertension)
  • High levels of creatinine in your blood. Creatinine is a waste product which can only be removed from the body by the kidneys: the creatinine level in the blood goes up when the efficiency of kidney function drops.

IgA nephropathy diagnosis

At present, doctors can only diagnose IgAN by using a medical procedure called a kidney biopsy to take small samples of the kidney away to look at under a microscope.

Blood and urine tests are also used to gauge kidney function.

IgA nephropathy treatment

Many people don’t realise they have the condition until it has damaged their kidneys.

Current treatments focus on:

  • Reducing blood pressure through regular exercise, weight control, and eating a healthy, reduced salt diet
  • Reducing protein in the urine by managing blood pressure
  • Choosing blood pressure medications which can specifically reduce proteinuria

You may also be offered medications called immunosuppressives which dampen down your immune system.

Your hospital may also invite you to take part in a clinical trial of one of the new drugs being tested to see if they are effective in IgAN.

In November 2023, NICE issued final draft guidance recommending the use of the first licensed treatment for IgAN, called targeted-release budesonide. Targeted-release budesonide is a type of corticosteroid (a drug that mimics the effects of hormones produced by the adrenal glands) that reduces the production of IgA antibodies in the small intestine to prevent build-up in the kidneys which causes inflammation and scarring, ultimately leading to potential kidney failure. Budesonide will only be used as an add-on to existing care alongside angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs).

IgA nephropathy progression

It can be difficult to predict how or if the disease will develop. IgAN is a variable condition, so a number of things could happen:

  • It could go away completely (not very common)
  • It could stay the same for years
  • Your kidneys may slowly lose function
  • Your kidneys may fail completely, which could lead to you eventually requiring dialysis or a kidney transplant
  • IgAN may recur after a kidney transplant

Help for you

If you have been diagnosed with IgAN and have any questions or concerns about your illness don’t hesitate to speak to your kidney specialist or your nurse specialist at your kidney unit.

You can also find further information, advice and helpful tips in our Just diagnosed  and How can I help myself? sections.

There is an annual UK IgAN Patient Information Day where patients and carers meet and discuss their experience of living with IgAN and are given up-to-date information on progress in research and clinical trials in IgAN.

Professor Fred Tam

"Knowing that people like Dr Fred Tam are on the case, looking for a cure, gives me hope."

Professor Fred Tam

Researcher spotlight

Professor Fred Tam has been researching to see if the drug fostamatinib could inhibit an immune system response after a blood transfusion – transfusions create the same immune response in the body as a transplant. Results showed when fostamatinib was given 24 hours after blood transfusion, it prevented the production of antibodies in a laboratory model. When the treatment was delayed by seven days there was still a small reduction in the number of antibodies.

The hope is that within the next 10 years, clinicians will be using fostamatinib to treat kidney patients, to stop their immune systems attacking their kidneys, and prevent kidney failure. This dream is within reach. But there is a lot more work to do.

Our IgAN research

Our research is changing the lives for people living with kidney disease but more needs to be done.

Our life-saving research is only possible with your support.

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