When you have IgA nephropathy, your immune system makes an abnormal version of a protein called immunoglobulin A (IgA). This abnormal IgA inflames and damages your kidneys. There's no cure for IgA nephropathy, but treatments can manage your symptoms and slow kidney damage.
Nephrologists are kidney specialists who treat IgA nephropathy. Your doctor will create a treatment plan to relieve your symptoms and slow kidney damage. Treatments for IgA nephropathy include medicine, diet changes, and sometimes a kidney transplant.
Treatments for IgA Nephropathy
IgA nephropathy medicines control blood pressure, bring down inflammation, and remove extra fluid from your body.
High blood pressure medicines. Your kidneys help to control your blood pressure. Kidney damage from IgA nephropathy can make your blood pressure rise. High blood pressure damages your kidneys even more. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are medicines that lower blood pressure. Sparsentan (Filspari) blocks both angiotensin and endothelin, a protein that narrows your blood vessels and raises blood pressure. These medicines also reduce the amount of protein that your kidneys leak into your pee.
Medicines to protect your kidneys. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are diabetes medicines that may reduce protein in the urine and help slow kidney disease. You take them by mouth as a pill.
Immune-suppressing medicines. Corticosteroids calm your immune system so that it doesn't damage the filters in your kidneys. If IgA nephropathy gets worse, your doctor may prescribe these medicines to slow damage to your kidneys. You can only take a steroid medicine for a short time – usually less than 6 months – because of the risk of side effects like high blood pressure, weight gain, and infections. Budesonide (Tarpeyo) is a newer type of corticosteroid that reduces the amount of protein the kidneys release into the urine. Your doctor might prescribe this medicine if your kidney disease is likely to get worse quickly.
Statins. High cholesterol is a complication of IgA nephropathy. Extra cholesterol builds up in arteries and forms sticky plaques. High cholesterol increases your risk of a heart attack. Statins lower cholesterol and protect your heart.
Diuretics. These medicines help your body get rid of extra water. They also reduce swelling in your hands and feet.
Tonsil removal. Immune cells in your tonsils make the IgA that builds up in and damages the filters inside your kidneys. Surgery to remove the tonsils may protect the kidneys and help some people with IgA nephropathy live longer. This surgery is mainly for people who get a lot of tonsil infections, and it is not commonly performed in the United States for treatment of IgA nephropathy.
Treatments for Kidney Failure
If IgA damages your kidneys so much that they don’t work well enough to meet your body’s needs, you will need dialysis or a kidney transplant.
Dialysis. This treatment removes extra fluid and wastes from your blood. You will need dialysis (or a kidney transplant) if your kidneys have failed.
Kidney transplant. End-stage renal disease, or kidney failure, is when your kidneys can’t filter your blood well enough. Between 10% and 30% of people with IgA nephropathy have kidney failure within 10 years after their diagnosis. A kidney transplant replaces your damaged kidney with a healthy kidney from a donor. A kidney transplant is not a cure. There is still a risk that the new kidney could develop IgA nephropathy. Blood pressure medicines can help to protect the transplanted kidney.
Lifestyle Changes to Protect Your Kidneys
Medicine is only one part of IgA nephropathy treatment. A few changes to your daily routine will also protect your kidneys and improve your health overall.
Eat less salt. Too much sodium raises blood pressure. Cutting down on salt may help lower your blood pressure and reduce swelling in your body.
Drink less fluid. It’s hard for damaged kidneys to remove extra water from your body, and some people may need to drink less fluid if there is too much fluid buildup in the body.
Stop smoking. It speeds up kidney damage from IgA nephropathy. If you have trouble quitting on your own, ask your doctor for help.
Cut down on protein. When you eat too much protein, your kidneys have to work harder to remove it from your body. Ask your doctor if you should cut down on high-protein foods like chicken and red meat.
Get more omega-3 fatty acids. These healthy fats may help reduce inflammation in your kidneys. You can get omega-3s from fatty fish like salmon, tuna, and sardines. They’re also in flaxseeds, soybean and canola oils, and walnuts. If you don’t get enough omega-3s from diet alone, your doctor might suggest that you take a fish oil supplement.
New Treatments in the Pipeline
Researchers have learned more about what causes IgA nephropathy and how it damages the kidneys. What they’ve learned has led to new medicines that slow the disease and protect the kidneys. Now researchers are studying other possible treatments in clinical trials.
The goals of new treatments are to:
- Make the immune system produce less abnormal IgA
- Reduce inflammation and scars in the kidneys and slow kidney damage
- Prevent complications of kidney damage
These are some of the medicines that have shown promise for IgA nephropathy:
- The immune-suppressing medicine mycophenolate mofetil may slow the disease.
- Hydroxychloroquine (Plaquenil) may help to reduce how much protein the kidneys release into the urine.
Enrolling in a clinical trial could give you the chance to try one of these medicines or other new treatments for IgA nephropathy before they're available to everyone else. Your kidney doctor can tell you whether any studies are a good fit for you.
Vaccines
Kidney disease could increase your risk of getting serious infections. Stay up to date on your vaccines to protect yourself.
You may need these vaccines if you haven't gotten them already and you have advanced kidney disease, you're on dialysis, or you've had a kidney transplant:
- Chickenpox
- COVID-19
- Flu
- Hepatitis B (HBV)
- Human papillomavirus (HPV)
- Measles, mumps, and rubella (MMR)
- Pneumonia
- Respiratory syncytial virus (RSV) if you are over age 60
- Shingles
- Tetanus, diphtheria, and pertussis (Tdap)
If you've had a kidney transplant, it's not safe for you to get live vaccines like the flu (live version), chickenpox, and MMR. Ask your doctor which vaccines you should get and when to get them.
Check Your Progress
Your doctor will do regular checkups and tests to see how well your treatments are working and if IgA nephropathy is getting worse. It's important to stay on the treatment plan your doctor prescribed. If you have any side effects, don't stop your medicine. Ask your doctor what you can do to prevent or manage treatment side effects.
Show Sources
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