Nefropatia iga (choroba bergera)

Nefropatia iga (choroba bergera)
Objawy

IgA nephropathy (nefropatia IgA, choroba Bergera) to przewlekła glomerulopatia charakteryzująca się depozycją immunoglobuliny A w kłębuszkach nerkowych, prowadzącą do ich zapalenia i uszkodzenia. Początkowo przebiega bezobjawowo, często wykrywana przypadkowo podczas rutynowych badań moczu, gdzie stwierdza się mikroskopowy krwiomocz i białkomocz. Typowym wczesnym objawem jest nawracający makroskopowy krwiomocz, zwłaszcza po infekcjach górnych dróg oddechowych (krwiomocz synfaryngityczny). W miarę progresji choroby pojawiają się obrzęki, nadciśnienie tętnicze, osłabienie, zmęczenie oraz nasilony krwiomocz i białkomocz, a w stadium 5 dochodzi do ciężkiego uszkodzenia nerek z objawami niewydolności, takimi jak oliguria, duszność i obrzęki. Kluczowymi czynnikami ryzyka szybkiej progresji są przewlekłe nadciśnienie, utrzymujący się białkomocz powyżej 1 g/dobę, podwyższony poziom kreatyniny, rozległa śródmiąższowa fibroza oraz pochodzenie wschodnioazjatyckie. Około 20-50% pacjentów rozwija schyłkową niewydolność nerek w ciągu 10-20 lat od rozpoznania.

Objawy IgA nephropathy (choroby Bergera)

IgA nephropathy (nefropatia IgA, choroba Bergera) to choroba nerek charakteryzująca się odkładaniem się przeciwciał immunoglobuliny A (IgA) w kłębuszkach nerkowych, co prowadzi do ich zapalenia i uszkodzenia. Objawy tej choroby są zróżnicowane i mogą pozostać niezauważone przez wiele lat, co sprawia, że wczesne rozpoznanie bywa trudne¹².

Wczesne objawy choroby

W początkowych etapach IgA nephropathy często przebiega bezobjawowo. Pacjenci mogą nie zauważać żadnych objawów nawet przez 10 lat lub dłużej. Choroba bywa przypadkowo wykryta podczas rutynowych badań lekarskich, gdy stwierdza się obecność białka i czerwonych krwinek w moczu widocznych pod mikroskopem¹³.

Najczęstszymi wczesnymi objawami IgA nephropathy są:

Krwiomocz – obecność krwi w moczu, nadająca mu kolor ciemnobrązowy, czerwony lub podobny do herbaty/coli. Często pojawia się po przeziębieniu, infekcji gardła lub infekcji dróg oddechowych¹⁴⁵
Piankowaty mocz – spowodowany przez białko przedostające się do moczu (proteinuria)¹⁵
Ból w dolnej części pleców – po jednej lub obu stronach pod żebrami¹³

Charakterystycznym objawem we wczesnym stadium choroby jest nawracający krwiomocz makroskopowy pojawiający się podczas lub krótko po infekcji górnych dróg oddechowych (tzw. krwiomocz synfaryngityczny). Jest to szczególnie częste u dzieci i młodych dorosłych, staje się rzadsze u starszych pacjentów⁶⁷.

Objawy postępującej choroby

Wraz z postępem choroby mogą pojawić się bardziej zauważalne objawy:

Obrzęki (dłoni, stóp, twarzy) – związane z retencją płynów¹⁴
Nadciśnienie tętnicze – często rozwija się szybko i może być ciężkie¹⁸
Osłabienie i zmęczenie – związane z pogarszającą się funkcją nerek¹²
Nasilony krwiomocz i białkomocz – większe ilości krwi i białka w moczu⁹

W stadium 3 IgA nephropathy (umiarkowane uszkodzenie nerek) niektórzy pacjenci zaczynają odczuwać wyraźne objawy, takie jak obrzęki dłoni i stóp oraz uczucie osłabienia i zmęczenia. W stadium 4 (umiarkowane do ciężkiego uszkodzenie nerek) objawy obejmują obrzęki oraz ból w dolnej części pleców².

Objawy związane z niewydolnością nerek

Jeśli choroba prowadzi do niewydolności nerek, mogą pojawić się następujące objawy¹³:

Wysypki i świąd skóry
Skurcze mięśni
Zaburzenia żołądkowe i wymioty
Zmniejszony apetyt
Metaliczny posmak w ustach
Zaburzenia świadomości

W zaawansowanym stadium choroby (stadium 5), gdy występuje ciężkie uszkodzenie nerek, mogą pojawić się dodatkowe objawy, takie jak trudności z oddychaniem, wytwarzanie małej ilości moczu lub jego brak, utrata apetytu oraz nasilenie obrzęków dłoni i stóp².

Przebieg i progresja choroby IgA nephropathy

IgA nephropathy to schorzenie przewlekłe o zróżnicowanym przebiegu klinicznym. Tempo progresji choroby znacznie różni się u poszczególnych pacjentów, co utrudnia prognozowanie jej rozwoju w indywidualnych przypadkach¹⁴.

Wzorce przebiegu choroby

Przebieg IgA nephropathy może przyjmować różne formy¹⁰:

Całkowite ustąpienie – zdarza się rzadko, częściej u dzieci
Stabilna choroba – nerki mogą funkcjonować prawidłowo przez wiele lat, wymagając jedynie regularnych kontroli
Powolna progresja – stopniowa utrata funkcji nerek wymagająca monitorowania
Prowadząca do niewydolności nerek – konieczność dializy lub przeszczepu nerki

U większości osób choroba postępuje powoli przez 10-20 lat i nie wszystkie przypadki osiągną stadium niewydolności nerek. Niektórzy pacjenci mogą żyć przez lata z niewielkimi objawami lub bez nich²¹¹.

Czynniki wpływające na progresję

Istnieje kilka kluczowych czynników, które mogą przyspieszać postęp choroby i wiążą się z gorszym rokowaniem⁵¹²¹³:

Przewlekłe nadciśnienie tętnicze
Utrzymujący się krwiomocz
Przedłużająca się proteinuria (powyżej 1 g/dobę)
Podwyższony poziom kreatyniny w surowicy
Rozległa śródmiąższowa fibroza nerek
Płeć męska
Hiperlipidemia
Starszy wiek
Rodzinne występowanie choroby
Pochodzenie wschodnioazjatyckie

Stopień białkomoczu, nadciśnienie tętnicze i obniżony GFR w momencie biopsji są najsilniejszymi predyktorami niekorzystnego wyniku. Ryzyko przewlekłej choroby nerek wzrasta wraz z wyższym poziomem białkomoczu¹³¹⁴.

Tempo progresji i rokowanie

IgA nephropathy zazwyczaj postępuje powoli, choć istnieje znaczna zmienność w jej przebiegu⁴¹⁵:

Około 20-50% pacjentów rozwinie schyłkową niewydolność nerek w ciągu 10-20 lat od diagnozy¹⁶¹²
Około 1 na 4 dorosłych z IgA nephropathy ostatecznie rozwinie niewydolność nerek⁹¹⁷
Badania sugerują, że choroba może skrócić oczekiwaną długość życia o około 10 lat⁴

Do 50% pacjentów doświadcza łagodnego przebiegu choroby, która nie powoduje znaczącego uszkodzenia nerek¹⁶. Izolowany krwiomocz mikroskopowy z łagodnym białkomoczem wskazuje na korzystne rokowanie, sugerując łagodny i bezobjawowy przebieg choroby⁷.

Powikłania choroby

Wraz z postępem IgA nephropathy mogą rozwinąć się różne powikłania¹¹⁸:

Nadciśnienie tętnicze – uszkodzenie nerek spowodowane odkładaniem się IgA może podwyższać ciśnienie krwi, a wysokie ciśnienie krwi może powodować dalsze uszkodzenie nerek
Podwyższony poziom cholesterolu – zwiększający ryzyko zawału serca
Ostra niewydolność nerek – gdy nerki nie filtrują krwi wystarczająco dobrze z powodu nagromadzenia IgA, poziom produktów przemiany materii szybko rośnie we krwi
Przewlekła choroba nerek – IgA nephropathy może z czasem doprowadzić do zaprzestania pracy nerek, wtedy konieczna jest dializa lub przeszczep nerki
Zespół nerczycowy – grupa problemów spowodowanych uszkodzeniem kłębuszków. Problemy mogą obejmować wysoki poziom białka w moczu, niski poziom białka we krwi, wysoki poziom cholesterolu i lipidów oraz obrzęk powiek, stóp i okolic brzucha

W przypadku postępu choroby do schyłkowej niewydolności nerek, pacjent będzie wymagał leczenia nerkozastępczego – dializy lub przeszczepu nerki⁴¹.

Nawrót po przeszczepie

IgA nephropathy może nawrócić po przeszczepie nerki ze względu na genetyczną podatność na chorobę. U około 20-40% pacjentów dochodzi do nawrotu choroby po przeszczepie, zazwyczaj w ciągu 2,5 roku od transplantacji, choć może to nastąpić wcześniej lub później⁵¹⁹.

Charakterystyka stadiów choroby

IgA nephropathy można podzielić na stadia, które odzwierciedlają stopień uszkodzenia nerek i ich funkcji. Każde stadium wpływa na nerki w nieco odmienny sposób i wiąże się z różnymi objawami².

Stadium 1: Wczesne uszkodzenie

W stadium 1 IgA nephropathy funkcja nerek pozostaje prawidłowa, ale rozpoczyna się łagodne uszkodzenie nerek²:

Pacjenci zazwyczaj nie mają zauważalnych objawów
Możliwe niedawne przeziębienie lub infekcja górnych dróg oddechowych, które wyzwoliły początek IgA nephropathy
Badania moczu mogą wykazać mikroskopowy krwiomocz lub niewielki białkomocz

Stadium 2: Łagodna utrata funkcji

W stadium 2 pojawia się łagodna utrata funkcji nerek, chociaż nerki nadal działają stosunkowo dobrze²:

Pacjent może nie zauważać wielu widocznych objawów
Badania laboratoryjne mogą wykazać postępujące zmiany w parametrach nerkowych
Może pojawiać się okresowy krwiomocz, zwłaszcza po infekcjach

Stadium 3: Umiarkowane uszkodzenie

W stadium 3 występuje łagodne do umiarkowanego uszkodzenie nerek. Nerki nie funkcjonują tak dobrze, jak powinny i nie są w stanie usuwać odpadów i nadmiaru płynów z krwi w sposób prawidłowy²:

Niektórzy pacjenci zaczynają doświadczać zauważalnych objawów
Może pojawić się wyraźny obrzęk dłoni i stóp
Pacjent może odczuwać osłabienie i zmęczenie
Nadciśnienie tętnicze staje się bardziej widoczne

Stadium 4: Zaawansowane uszkodzenie

W stadium 4 występuje umiarkowane do ciężkiego uszkodzenie nerek. Nerki nie pracują dobrze, aby skutecznie filtrować odpady z krwi²:

Objawy takie jak obrzęk dłoni i stóp lub ból w dolnej części pleców zazwyczaj się nasilają
Znaczny wzrost ciśnienia krwi
Zwiększone stężenie toksyn we krwi
Wyraźny białkomocz i krwiomocz

Stadium 5: Niewydolność nerek

W ostatnim stadium IgA nephropathy występuje ciężkie uszkodzenie nerek. To stadium znacznie zwiększa ryzyko niewydolności nerek, gdy nerki nie mogą już funkcjonować²:

Pacjent prawdopodobnie czuje się bardzo chory z powodu nagromadzenia odpadów w organizmie
Trudności z oddychaniem
Wytwarzanie małej ilości moczu lub jego brak
Brak apetytu
Ciężki obrzęk stóp i dłoni
Mogą wystąpić inne problemy zdrowotne

W tym stadium konieczne jest leczenie nerkozastępcze (dializa lub przeszczep nerki)²⁰.

Wpływ IgA nephropathy na jakość życia

IgA nephropathy może znacząco wpływać na jakość życia pacjentów, szczególnie gdy choroba postępuje i pojawiają się bardziej nasilone objawy²⁴.

Ograniczenia w codziennym funkcjonowaniu

Wraz z postępem choroby pacjenci mogą doświadczać²²¹:

Obrzęków i zmęczenia, które mogą zakłócać codzienne czynności
Trudności ze snem w zaawansowanych stadiach choroby
Problemów z pamięcią związanych z nagromadzeniem toksyn
Utraty apetytu
Problemów z oddawaniem moczu

Osoby z IgA nephropathy mogą również doświadczać ograniczeń w wysiłku fizycznym, szczególnie gdy pojawia się krwiomocz po intensywnym wysiłku⁸.

Aspekty psychologiczne i społeczne

Choroba może mieć również istotny wpływ na zdrowie psychiczne i relacje społeczne pacjentów⁴²²:

Stres związany z niepewnością co do progresji choroby
Lęk dotyczący możliwej niewydolności nerek i konieczności dializy lub przeszczepu
Wpływ na relacje z bliskimi i aktywność zawodową
Potrzeba regularnych kontroli lekarskich i przestrzegania zaleceń terapeutycznych

Rokowanie długoterminowe

Przy właściwym leczeniu i monitorowaniu, wiele osób z IgA nephropathy może prowadzić długie i satysfakcjonujące życie⁴²²:

Mogą kontynuować pracę, naukę i uczestniczyć w ulubionych aktywnościach
Życie osób z IgA nephropathy nie powinno zasadniczo różnić się od życia osób bez tego schorzenia, zwłaszcza we wczesnych stadiach choroby⁶
Skuteczne leczenie może znacząco spowolnić postęp choroby i zapobiec lub opóźnić jej powikłania²²

Wczesna diagnoza i odpowiednie strategie leczenia umożliwiają opóźnienie lub zapobieganie progresji choroby, co znacznie poprawia rokowanie długoterminowe i jakość życia pacjentów².

Znaczenie wczesnego rozpoznania i monitorowania

Wczesne rozpoznanie IgA nephropathy ma kluczowe znaczenie dla spowolnienia progresji choroby i zapobiegania rozwojowi niewydolności nerek. Ze względu na bezobjawowy początek choroby, diagnoza często następuje przypadkowo podczas rutynowych badań²²³.

Kluczowe markery progresji

Regularne monitorowanie określonych parametrów pozwala ocenić aktywność choroby i ryzyko jej postępu¹²¹³:

Białkomocz – poziom białka w moczu jest ważnym wskaźnikiem nasilenia choroby i rokowania. Utrzymujący się i znaczący białkomocz może wiązać się ze zwiększonym ryzykiem progresji do przewlekłej choroby nerek²⁴
Krwiomocz – utrzymujący się lub nawracający krwiomocz wskazuje na aktywność choroby⁵
Ciśnienie tętnicze – kontrola ciśnienia jest istotna w zarządzaniu IgA nephropathy, aby spowolnić postęp uszkodzenia nerek²⁴
GFR (wskaźnik filtracji kłębuszkowej) – monitorowanie GFR pozwala ocenić funkcję nerek i tempo progresji choroby²⁴

Nawet pacjenci z niższymi poziomami białka w moczu są zagrożeni progresją do schyłkowej niewydolności nerek, co podkreśla znaczenie wczesnej interwencji i leczenia²³.

Regularność kontroli lekarskich

Pacjenci z IgA nephropathy powinni być regularnie monitorowani przez nefrologa, aby ocenić funkcję nerek i dostosować leczenie²⁵:

Regularne badania moczu w kierunku białkomoczu i krwiomoczu
Okresowe badania krwi oceniające poziom kreatyniny i GFR
Kontrola ciśnienia tętniczego
Ocena skuteczności stosowanych leków i ewentualna modyfikacja leczenia

Częstotliwość wizyt kontrolnych powinna być dostosowana do stadium choroby i tempa jej progresji²⁵.

Przebieg IgA nephropathy – podsumowanie

IgA nephropathy to przewlekła choroba, której przebieg jest bardzo zróżnicowany i nieprzewidywalny⁴²². Kluczowe aspekty przebiegu choroby obejmują:

Powolna progresja – choroba zwykle rozwija się stopniowo przez 10-20 lat²
Zróżnicowane rokowanie – od łagodnych form bez znaczącego uszkodzenia nerek do postaci prowadzących do schyłkowej niewydolności nerek¹⁶
Około 20-50% pacjentów rozwinie niewydolność nerek w ciągu 10-20 lat od diagnozy¹⁶¹²
Identyfikacja czynników ryzyka szybkiej progresji (wysoki białkomocz, nadciśnienie, podwyższona kreatynina) pozwala na wdrożenie intensywnego leczenia u pacjentów najbardziej zagrożonych⁵¹³
Wczesna diagnoza i odpowiednie leczenie mogą znacząco spowolnić postęp choroby i zapobiec lub opóźnić rozwój niewydolności nerek²

Pacjenci z IgA nephropathy powinni pozostawać pod stałą opieką nefrologiczną, przestrzegać zaleceń dotyczących leków i stylu życia oraz regularnie monitorować funkcję nerek, aby osiągnąć optymalne wyniki leczenia i utrzymać dobrą jakość życia²²²³.

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Materiały źródłowe

#1 IgA nephropathy (Berger disease) – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/iga-nephropathy/symptoms-causes/syc-20352268
IgA nephropathy often doesn’t cause symptoms early on. You might not notice any health effects for 10 years or more. Sometimes, routine medical tests find signs of the disease, such as protein and red blood cells in the urine that are seen under a microscope. […] When IgA nephropathy causes symptoms, they might include: Cola- or tea-colored urine caused by blood. You might notice these color changes after a cold, sore throat or respiratory infection. Blood that can be seen in the urine. Foamy urine from protein leaking into the urine. This is called proteinuria. Pain on one or both sides of the back below the ribs. Swelling in the hands and feet called edema. High blood pressure. Weakness and tiredness. […] If the disease leads to kidney failure, symptoms may include: Rashes and itchy skin. Muscle cramps. Upset stomach and vomiting. Less appetite. Metallic taste in the mouth. Confusion.
#1 IgA nephropathy (Berger disease) – Symptoms and causes – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/iga-nephropathy/symptoms-causes/syc-20352268
Kidney failure is life-threatening without treatment. But dialysis or a kidney transplant can help people live for many more years. […] The course of IgA nephropathy varies from person to person. Some people have the disease for years with few or no problems. Many don’t get diagnosed. Other people develop one or more of the following complications: High blood pressure. Damage to the kidneys from IgA buildup can raise blood pressure. And high blood pressure can do more damage to the kidneys. High cholesterol. High levels of cholesterol can raise the risk of a heart attack. Acute kidney failure. If the kidneys can’t filter blood well enough due to buildup of IgA, levels of waste products rise quickly in the blood. And if kidney function gets worse very quickly, health care professionals may use the term rapidly progressive glomerulonephritis. Chronic kidney disease. IgA nephropathy can cause the kidneys to stop working over time. Then a treatment called dialysis or a kidney transplant is needed to live. Nephrotic syndrome. This is a group of problems that can be caused by damage to the glomeruli. The problems can include high urine protein levels, low blood protein levels, high cholesterol and lipids, and swelling of the eyelids, feet and stomach area.
#2 IgA Nephropathy: Stages, Symptoms, Diagnosis, Treatment
https://www.health.com/iga-nephropathy-stages-8702883
Immunoglobulin A nephropathy (also known as IgA nephropathy or Berger’s disease) is a condition that causes IgA antibodies to accumulate in the kidneys leading to damage that affects their blood-filtering function. Each stage of this condition affects your kidneys a bit differently. […] It’s worth noting that the progression of IgA nephropathy can be slowed down or prevented, so seeking a diagnosis when you start experiencing symptoms is essential. While the course of the disease can vary by person, IgA nephropathy typically progresses slowly for 10 to 20 years and not all cases will reach the kidney failure stage. […] In stage 1 of IgA nephropathy, you’ll still have normal kidney function but mild kidney damage is starting to occur. […] You likely won’t have noticeable symptoms, but you may have recently experienced a cold or upper respiratory infection that triggered the onset of IgA nephropathy.
#2 IgA Nephropathy: Stages, Symptoms, Diagnosis, Treatment
https://www.health.com/iga-nephropathy-stages-8702883
You’re likely feeling very ill due to the buildup of waste in the body, and possibly experiencing other health concerns. Some of the key symptoms during this stage include: Trouble breathing, Producing little or no urine, Lack of appetite, Severe swelling of your feet and hands. […] While IgA nephropathy is not curable, an early diagnosis and the right treatment strategies make it possible to delay or prevent the progression of the disease. […] The stages of IgA nephropathy can affect people in different ways. Some people don’t experience many noticeable symptoms or adverse health effects, while others may live with severe symptoms and go on to develop kidney failure. […] The early stages of IgA nephropathy may not entail intense symptoms. One notable sign may be experiencing blood in your urine after a cold or upper respiratory infection, which experts have found to be a trigger for the development of IgA nephropathy. […] As IgA nephropathy progresses, symptoms can affect your quality of life and complications may start to occur. This might include swelling and fatigue that interrupt your daily routine.
#2 IgA Nephropathy: Stages, Symptoms, Diagnosis, Treatment
https://www.health.com/iga-nephropathy-stages-8702883
There is a mild loss of kidney function as you reach stage 2 of IgA nephropathy. However, the kidneys still work relatively well, and you may not see many noticeable signs. […] In stage 3, mild to moderate kidney damage is occurring. Your kidneys aren’t functioning as well as they should and are unable to remove waste and excess fluid from your blood as normal. […] Some people start to experience noticeable symptoms at this time, like apparent swelling in the hands and feet or feeling weak and tired. […] Moderate to severe damage to the kidneys is occurring during stage 4. Your kidneys are not working well to effectively filter waste from your blood. […] If they haven’t yet, symptoms like swelling of the hands and feet or lower back pain typically manifest during this time. […] There is severe damage to the kidneys in the last stage of IgA nephropathy. This stage significantly increases your risk of kidney failure, where the kidneys can no longer function.
#3 IgA nephropathy (Berger disease) | Altru Health System
https://www.altru.org/health-library/conditions/iga-nephropathy-berger-disease
IgA nephropathy often becomes worse slowly over years. But the course of the disease varies from person to person. Some people leak blood into their urine without having other problems. Others might have complications such as losing kidney function and spilling protein into the urine. Still others develop kidney failure, which means the kidneys stop working well enough to filter the body’s waste on their own. […] IgA nephropathy often doesn’t cause symptoms early on. You might not notice any health effects for 10 years or more. Sometimes, routine medical tests find signs of the disease, such as protein and red blood cells in the urine that are seen under a microscope. […] When IgA nephropathy causes symptoms, they might include: Cola- or tea-colored urine caused by blood. You might notice these color changes after a cold, sore throat or respiratory infection. Blood that can be seen in the urine. Foamy urine from protein leaking into the urine. This is called proteinuria. Pain on one or both sides of the back below the ribs. Swelling in the hands and feet called edema. High blood pressure. Weakness and tiredness.
#3 IgA nephropathy (Berger disease) | Altru Health System
https://www.altru.org/health-library/conditions/iga-nephropathy-berger-disease
If the disease leads to kidney failure, symptoms may include: Rashes and itchy skin. Muscle cramps. Upset stomach and vomiting. Less appetite. Metallic taste in the mouth. Confusion. […] Kidney failure is life-threatening without treatment. But dialysis or a kidney transplant can help people live for many more years.
#4 IgA Nephropathy (Berger Disease): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/5990-iga-nephropathy
IgA nephropathy, or Bergers disease, is a kidney disease in which IgA antibodies build up abnormally. Over time, it leads to kidney damage or kidney failure. Symptoms include blood in your pee, swelling and flank pain. […] Common IgA nephropathy symptoms include flank pain, swelling, hematuria and foamy pee. IgA nephropathy symptoms may take time to appear. But common symptoms include urinary changes, flank pain and swelling. […] The most common IgA nephropathy symptoms include: Visible blood in your pee, Flank pain, Swelling (edema), especially in your legs, ankles, abdominal area or face, Foamy urine. […] You may not have any IgA nephropathy symptoms at first. It can be years or even decades before signs appear. […] Without treatment, IgA nephropathy may gradually get worse and cause kidney failure (renal failure). Kidney failure is fatal without treatment.
#4 IgA Nephropathy (Berger Disease): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/5990-iga-nephropathy
It depends. Sometimes, IgA nephropathy gets better with conservative treatment. In rare cases, IgA nephropathy progresses rapidly. Kidney failure can develop within a few years. […] With the right treatment, many people can keep their kidneys as healthy as possible and slow the diseases progression. […] About 1 in 4 adults with IgA nephropathy eventually develop kidney failure. About 1 in every 10 to 20 children with IgA nephropathy develop kidney failure. […] If IgA nephropathy progresses to kidney failure, you may need to consider dialysis or a kidney transplant. […] IgA nephropathy is typically a lifelong, progressive kidney disease. That means it usually gets worse as time goes on. But medications can help slow the conditions progression. […] A 2017 study of adults with IgA nephropathy in the southeastern U.S. found that life expectancy is reduced by a little over 10 years. The average age of death was just under 66 years, while the expected age of death if you dont have kidney disease was just under 76 years. […] With proper treatment, many people with IgA nephropathy can live long, fulfilling lives. They can continue working, going to school and participating in activities they love.
#5 IgA Nephropathy (Bergerâs Disease): Diet, Symptoms, and More
https://www.healthline.com/health/iga-nephropathy-bergers
IgA nephropathy (Bergers disease) is a chronic kidney disease that occurs when immunoglobulin A (IgA) deposits build up in the kidneys. It can cause blood in the urine, among other symptoms. […] In the early stages of IgA nephropathy, the main symptom is blood in the urine. In medical terms, this is called hematuria. […] Symptoms usually start between ages 10 and 40. But they may go unnoticed for years because the amount of blood in the urine is small. […] If the disease progresses and starts to impair your kidney function, you may also experience: brown or tea-colored urine, pain on the side of your back (flank pain), protein in the urine (proteinuria), high blood pressure (hypertension), swelling of the hands and feet. […] In some people, IgA nephropathy may progress over a few decades and can eventually lead to kidney failure.
#5 IgA Nephropathy (Bergerâs Disease): Diet, Symptoms, and More
https://www.healthline.com/health/iga-nephropathy-bergers
For many people, IgA nephropathy progresses slowly. Some people may also develop kidney failure and other life threatening complications. […] Research from 2018 suggests having IgA nephropathy can decrease a persons lifespan by about 10 years. […] Roughly 20% of people with IgA nephropathy typically develop ESRD within 10 years of onset. Some signs may indicate an unfavorable prognosis, including: long-term hypertension, persistent blood in the urine, prolonged protein in the urine (above 1 gram/day), high serum creatinine level, widespread intestinal fibrosis of the kidneys. […] About 20-40% of people will have symptom recurrence after a kidney transplant. Recurrence typically happens within 2.5 years after transplantation but can occur before or after that.
#6 IgA Nephropathy (Berger’s Disease): ERKNet voor PatiÃ«nten
https://www.erknet.org/patients/nl/your-kidney-disease/iga-nephropathy/disease-information
During the course of the disease, the presence of recurrent macrohematuria during an upper respiratory tract infection is very characteristic, but mostly limited to children and young adults. It becomes very rare in older adults. Even in case of severe kidney disease and impaired kidney function, the symptoms can be inconspicuous, especially when the disease develops slowly, and the patient adapts to the changes. […] IgAN that comes to medical attention is usually a chronic and progressive disease. This means that it does not go away, and in some patients, it may worsen over time. However, there is also evidence that very mild cases of IgAN exist, that are never recognised and never cause clinical problems in particular kidney failure. Also, with optimal therapy, IgAN may become quiescent and kidney functions stabilizes or sometimes the disease completely disappears. […] The lives of children/adults with IgA nephropathy should not be fundamentally different from the lives of children/adults without the condition.
#7 IgA Nephropathy (Berger Disease) | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23357
Immunoglobulin A (IgA) nephropathy, or IgAN, is one of the leading causes of glomerulonephritis and renal failure. This disease is characterized by the deposition of IgA in the glomerular mesangium. Immune-mediated damage to the basement membrane results in hematuria, proteinuria, and renal insufficiency. The clinical course typically progresses gradually, yet between 20% and 50% of affected patients develop end-stage renal disease (ESRD) within 20 years of diagnosis. […] The primary complaint often revolves around gross hematuria, which can manifest as brown, red, or „coca-cola colored” urine. Acute renal failure may lead to ankle edema, facial puffiness, and hypertension. Other potential symptoms include frothy urine or the presence of a rash. Patients may report a recent history of URIs, such as pharyngitis, preceding the onset of hematuria.
#7 IgA Nephropathy (Berger Disease) | Treatment & Management | Point of Care
https://www.statpearls.com/point-of-care/23357
The range of clinical features of IgAN is broad, ranging from asymptomatic hematuria to rapidly progressive glomerulonephritis. The mode of presentation varies based on age group and histological biopsy patterns. Among the most prevalent clinical phenotypes are asymptomatic hematuria and progressive kidney disease. […] Synpharyngitic macroscopic hematuria is often the initial presentation of IgAN, with patients seeking medical attention due to the simultaneous occurrence of gross hematuria and pharyngitis or another infection. Recurrent episodes of macroscopic hematuria are also common. […] Up to 50% of IgAN patients experience a benign course. Prognosis can be somewhat predictable, particularly based on the Oxford classification outlined in the Pathology section. Any of the MEST criteria (and crescents) serve as poor prognostic indicators. Isolated microscopic hematuria with mild proteinuria suggests a favorable prognosis, indicating a benign and asymptomatic disease course. Additionally, individuals of East Asian origin are significantly associated with an elevated risk of ESRD.
#8 IgA Nephropathy: Symptoms You Should Know About | myIgANcenter
https://kidneydisease.myhealthteam.com/resources/iga-nephropathy-symptoms-you-should-know-about
You may notice blood in your urine during or after a respiratory infection, such as a cold, or after vigorous exercise. […] Foamy urine may be a result of too much protein in your urine. This condition is known as proteinuria, and its another sign that IgA nephropathy may be damaging your kidneys. […] As IgAN progresses, your kidneys become more damaged and can no longer function as well as they should. You may begin experiencing kidney disease symptoms and, in severe cases, end-stage kidney disease symptoms. One of these is edema (swelling). […] Extra fluid in your body puts more stress on your blood vessels, causing your blood pressure to rise. High blood pressure caused by kidney disease often develops quickly and can be severe. […] If youve noticed one or more symptoms of IgAN recently, make an appointment to talk to your doctor or nephrologist. They can run a series of tests to measure your kidney function and make a diagnosis. The sooner you begin treatment, the fewer complications youre likely to have.
#9 IgA Nephropathy (IgAN) | National Kidney Foundation
https://www.kidney.org/kidney-topics/iga-nephropathy
IgA nephropathy (IgAN) is a type of kidney disease where antibodies build up in your kidneys and cause damage to your glomeruli (small filters inside your kidneys). […] Many people with IgAN may not have any symptoms at first. As the disease advances, symptoms usually start to appear. If symptoms are present, you may notice one or more of the following: Foamy urine, Puffiness around the eyes (especially in the morning), Swelling of your legs, feet, ankles, belly area, or face, Hematuria (blood in your urine), especially if it starts during or soon after a cold, sore throat, or respiratory infection. […] One of the earliest signs of kidney damage from IgAN is the leaking of blood and/or protein (albumin) into your urine. Without treatment, this can get worse over time and lead to complications. […] Around 1 in 5 people with IgA nephropathy develop kidney failure within 10 years of diagnosis.
#10 IgA Nephropathy (Bergerâs Disease): Causes, Symptoms, & Treatment
https://www.webmd.com/a-to-z-guides/what-is-iga-nephropathy
If you have IgA nephropathy for a long time, it raises your risk of complications such as: High blood pressure, Kidney failure that comes on suddenly, Losing kidney function slowly over time (chronic kidney failure), Nephrotic syndrome, which is a group of symptoms including high protein in your urine, swelling, and high cholesterol, Heart or cardiovascular problems. […] There are several ways your IgA can progress, including: It can go away completely (more common in kids), Kidneys may slowly lose function and require monitoring, Kidneys may stay the same for many years and require only regular checkups, It may lead to kidney failure, requiring dialysis or a kidney transplant. […] Research suggests that 20%-50% of people with IgA nephropathy will eventually develop kidney failure and need dialysis or a kidney transplant. That means many do not. Some studies have found that IgA nephropathy can decrease life expectancy, but with early detection and effective treatment, many people can live long lives while staying engaged in work as well as other important and enjoyable activities.
#11 Pediatric Berger’s disease (IgA nephropathy) – Children’s Health Nephrology
https://www.childrens.com/specialties-services/conditions/bergers-disease-iga-nephropathy
Berger’s disease, or IgA nephropathy (nephropathy), is a rare renal disease that causes swelling in the kidneys and can lead to kidney failure or end state renal (kidney) disease (ESRD). […] When a child’s body makes too much IgA (immunoglobulin A) protein, it can damage the glomeruli. This leads to your child having protein and blood in their urine, and other complications such as high blood pressure and kidney failure or end-stage renal disease (ESRD). […] The signs and symptoms of pediatric Berger’s disease (IgA nephropathy) include edema (swelling of the ankles, legs and face), hematuria, infrequent urination, proteinuria (protein in the urine), and red or dark brown colored urine (due to blood).
#12 IgA Nephropathy: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/239927-overview
Patients with IgA nephropathy (especially adults) may be asymptomatic, albeit with persistent microscopic hematuria and proteinuria and often hypertension. Symptomatic presentations include the following: […] Episodic gross hematuria […] Rapidly progressive glomerulonephritis […] Proteinuria- less than 3 g/day […] Nephrotic syndrome […] Chronic kidney disease. […] Although IgA nephropathy usually follows a benign course, end-stage kidney disease (ESKD) develops in 15-20% of patients within 10 years of onset and in about 25-30% of patients by 20 years. Efforts have been made to determine clinical and histologic features associated with progression to ESKD. […] Other predictors of poor renal outcomes include the following: High serum creatinine level ( 120 mmol/L) at presentation […] Hypertension (diastolic pressure 95 mm Hg or need for antihypertensive treatment) […] Proteinuria: Urinary protein excretion 1 g/24 hr is associated with 56% renal survival and 3.5 g/24 hr with 7% renal survival.
#13 IgA Nephropathy (Berger’s Disease) | Doctor
https://patient.info/doctor/iga-nephropathy-bergers-disease-pro
The degree of proteinuria and hypertension and presence of reduced eGFR at time of biopsy are the strongest predictors of poor outcome. The risk for CKD increases with higher levels of proteinuria. Histological features associated with a poor prognosis include segmental glomerulosclerosis, interstitial fibrosis, and endocapillary proliferation.
#14 IgA nephropathy Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/iga-nephropathy
IgA nephropathy is a kidney disorder in which antibodies (called IgA) build up in kidney tissue. […] IgA nephropathy can occur in people of all ages, but it most often affects males in their teens to late 30s. […] There may be no symptoms for many years. When there are symptoms, they may include: Bloody urine that starts during or soon after a respiratory infection, Repeated episodes of dark or bloody urine, Swelling of the hands and feet, Symptoms of chronic kidney disease. […] The disorder can appear suddenly (acute), or get worse slowly over many years (chronic glomerulonephritis). […] IgA nephropathy gets worse slowly. In many cases, it does not get worse at all. Your condition is more likely to get worse if you have: High blood pressure, Large amounts of protein in the urine, Increased BUN or creatinine levels.
#15 IgA Nephropathy Progression: Your FAQs
https://www.healthline.com/health/your-faqs-iga-nephropathy-progression
With IgA nephropathy, some people may experience little to no disease progression, while others may eventually experience end stage renal disease. […] Immunoglobulin A nephropathy (IgAN), or Bergers disease, is a chronic progressive disease. In some people, symptoms might not appear at all. Its possible for symptoms to lie dormant 10 or more years. […] In others, IgA nephropathy can progress and lead to kidney failure. […] IgA nephropathy doesnt always cause symptoms. Some people may have the disease without knowing, and in some, it can take years for symptoms to develop. […] One of the first indications IgA nephropathy may be present is blood or protein in the urine. […] Other symptoms of IgA nephropathy include fatigue, cold or flu symptoms, pain in the lower back, pain in the sides, weakness, and high blood pressure.
#16 IgA Nephropathy (Berger Disease) – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK538214/
Immunoglobulin A (IgA) nephropathy, or IgAN, also known as Berger disease, is one of the leading causes of glomerulonephritis and renal failure. This disease is characterized by the deposition of IgA in the glomerular mesangium. Immune-mediated damage to the basement membrane results in hematuria, proteinuria, and renal insufficiency. […] The clinical course typically progresses gradually, yet between 20% and 50% of affected patients develop end-stage renal disease (ESRD) within 20 years of diagnosis. […] The primary complaint often revolves around gross hematuria, which can manifest as brown, red, or „coca-cola colored” urine. Acute renal failure may lead to ankle edema, facial puffiness, and hypertension. Other potential symptoms include frothy urine or the presence of a rash. […] Asymptomatic hematuria with mild proteinuria, typically around 0.5 g/d, may be detected during routine screening. A subset of individuals presenting with isolated microscopic hematuria and mild proteinuria may eventually progress to develop substantial proteinuria and hypertension, underscoring the importance of long-term monitoring.
#16 IgA Nephropathy (Berger Disease) – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK538214/
Up to 50% of IgAN patients experience a benign course. […] Prognosis can be somewhat predictable, particularly based on the Oxford classification outlined in the Pathology section. Any of the MEST criteria (and crescents) serve as poor prognostic indicators. Isolated microscopic hematuria with mild proteinuria suggests a favorable prognosis, indicating a benign and asymptomatic disease course. Additionally, individuals of East Asian origin are significantly associated with an elevated risk of ESRD.
#17 IgA Nephropathy – NIDDK
https://www.niddk.nih.gov/health-information/kidney-disease/iga-nephropathy
IgA nephropathy is also known as Bergers disease. […] Symptoms can vary and may not appear for years or even decades. Common signs and symptoms include pink or cola-colored urine due to blood in your urine, called gross hematuria or visible hematuria, foamy urine from protein leaking into your urine, called proteinuria, swelling due to extra fluid in the legs, feet, ankles, or other parts of your body, called edema. […] About 1 in 5 people with IgA nephropathy develop kidney failure within 10 years of diagnosis. […] In many cases, IgA nephropathy does not get worse over time. But if the disease progresses to kidney failure, you may need a kidney transplant or blood-filtering treatments called dialysis.
#18 Mayo Clinic Health Library – IgA nephropathy (Berger disease) | Swiss Medical Network
https://www.swissmedical.net/en/healtcare-library/con-20166955
When IgA nephropathy causes symptoms, they might include: Cola- or tea-colored urine caused by blood. You might notice these color changes after a cold, sore throat or respiratory infection. Blood that can be seen in the urine. Foamy urine from protein leaking into the urine. This is called proteinuria. Pain on one or both sides of the back below the ribs. Swelling in the hands and feet called edema. High blood pressure. Weakness and tiredness. […] If the disease leads to kidney failure, symptoms may include: Rashes and itchy skin. Muscle cramps. Upset stomach and vomiting. Less appetite. Metallic taste in the mouth. Confusion. […] Kidney failure is life-threatening without treatment. But dialysis or a kidney transplant can help people live for many more years. […] The course of IgA nephropathy varies from person to person. Some people have the disease for years with few or no problems. Many don’t get diagnosed. Other people develop one or more of the following complications: High blood pressure. Damage to the kidneys from IgA buildup can raise blood pressure. And high blood pressure can do more damage to the kidneys. High cholesterol. High levels of cholesterol can raise the risk of a heart attack. Acute kidney failure. If the kidneys can’t filter blood well enough due to buildup of IgA, levels of waste products rise quickly in the blood. And if kidney function gets worse very quickly, health care professionals may use the term rapidly progressive glomerulonephritis. Chronic kidney disease. IgA nephropathy can cause the kidneys to stop working over time. Then a treatment called dialysis or a kidney transplant is needed to live. Nephrotic syndrome. This is a group of problems that can be caused by damage to the glomeruli. The problems can include high urine protein levels, low blood protein levels, high cholesterol and lipids, and swelling of the eyelids, feet and stomach area.
#19 IgA nephropathy (IgAN) | American Kidney Fund
https://www.kidneyfund.org/all-about-kidneys/other-kidney-diseases/iga-nephropathy
IgA nephropathy is a lifelong, progressive disease, meaning it will gradually worsen over time. For some people, the progression may be slow, and they may never reach kidney failure. However, for others, the disease can progress quickly, leading to kidney failure in just a matter of months. One key warning sign is proteinuria (protein in the urine). The more protein you have in your urine, the higher your risk of quick progression to kidney failure. […] While there are not always symptoms of proteinuria, the following can indicate high levels of proteinuria: […] It is possible for IgAN to reoccur after a kidney transplant. […] If you have kidney failure from IgA nephropathy, you will need to go on dialysis or have a kidney transplant. […] There is no cure for IgA nephropathy. The goal of treatment is to slow the damage to your kidneys and delay or prevent kidney failure.
#20 What to Expect as IgA Nephropathy Progresses
https://www.webmd.com/a-to-z-guides/iga-nephropathy-progression
End-stage kidney failure, or ESRD, is the last stage of kidney damage. At this point, your kidneys don’t work well enough to keep your body healthy. […] These are a few signs that your kidneys are no longer working, and it may be time for dialysis or a kidney transplant: Tiredness and weakness, Nausea and vomiting, Little to no urine when you pee, Itching, Weight loss, Headache, Poor appetite, Metallic taste. […] Kidney failure means you’ve lost more than 85 to 90 percent of your kidney function. Your kidneys won’t get better at this point, so you’ll need either dialysis or a kidney transplant to remove wastes and fluid. […] A kidney transplant is a more long-term treatment for kidney failure. It can give you the freedom of not having to do dialysis several times a week. Studies show that people who get a kidney transplant live longer than those who use dialysis.
#21 IgA Nephropathy: Signs and Symptoms
https://www.health.com/iga-nephropathy-symptoms-8706753
Symptoms of IgAN include dark-colored urine, frequent respiratory infections, and severe hypertension. […] 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, edema (swelling), bleeding and bruising, pain in the sides, fatigue and weakness, and gastrointestinal symptoms. […] Over time, IgA nephropathy can significantly damage the kidneys and increase the risk of end-stage kidney disease or kidney failure. […] 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. […] Symptoms during late-stage IgAN include sleep problems, difficulty with memory, loss of appetite, and trouble urinating.
#22 What is IgA Nephropathy? – Immunoglobulin A [Berger’s Disease]
https://igan.org/faq/
The prognosis for individuals with IgA nephropathy varies depending on the severity of the condition, kidney biopsy findings, the amount of protein in the urine, response to treatment, and overall kidney function. With proper management and medical care, many individuals with IgA nephropathy can lead a relatively normal life. […] Making lifestyle changes is essential for managing IgA nephropathy and supporting kidney health. This includes following a diet that is low in salt and protein and maintaining a healthy weight. Regular exercise, avoiding smoking, and limiting alcohol consumption are also important. […] IgA nephropathy progresses differently in each person. Some have mild symptoms for years, while others go undiagnosed. Complications may arise in some individuals. […] IgA nephropathy can lead to kidney failure, necessitating dialysis or a kidney transplant for survival.
#23 Navigating IgAN – NephCure
https://nephcure.org/intro-to-rkd/types-of-rkd/iga-nephropathy-igan/navigating-igan/
IgA nephropathy (IgAN) is a rare kidney disease that causes inflammation in the kidneyâs filtering units, which can result in kidney damage and may lead to kidney failure. […] IgAN, sometimes called IgA kidney disease or Bergerâs disease, often lurks silently in its early stages, potentially going undetected for years due to a lack of symptoms. IgAN can affect men and woman of any age, but most people are diagnosed as young and middle-aged adults. Up to 40% of people living with IgAN show no recognizable symptoms at initial diagnosis. This stealthy disease can advance unnoticed for years, quietly damaging kidneys. […] Despite its slow progression, there is a growing urgency to treat IgAN, as recent research reveals that even patients with lower levels of protein in their urine (proteinuria) are at risk of progressing to end-stage kidney disease (ESKD). Many patients with IgAN experience a delay in diagnosis because their symptoms or diagnostic tests are not taken seriously. If you are experiencing symptoms, such as proteinuria, be sure that your doctor is actively addressing them. Watching and waiting without treatment can lead to irreversible kidney damage.
#23 Navigating IgAN – NephCure
https://nephcure.org/intro-to-rkd/types-of-rkd/iga-nephropathy-igan/navigating-igan/
Signs and Symptoms of IgA Nephropathy: Blood in the urine (hematuria) […] Protein in the urine (proteinuria), which can be foamy […] Dark or âcolaâ colored urine after a viral infection (cold, respiratory illness, sore throat) […] High blood pressure […] Swelling in the face, eyes, and lower extremities […] High cholesterol […] Fatigue […] Joint pain or pain in and around the kidneys. […] While there is no cure for IgAN, for the first time, there are multiple FDA-approved treatment options to specifically treat IgAN. Starting these treatments as early on in your diagnosis as possible can help preserve your kidney function. Take charge of your health and act nowârecent advancements in research and drug development offer new opportunities that can help you stop disease progression!
#24 Immunoglobulin A Nephropathy: 5 Things to Know | MDedge
https://blogs.the-hospitalist.org/content/immunoglobulin-nephropathy-5-things-know
Immunoglobulin A (IgA) nephropathy, also known as Berger disease, is a kidney disorder characterized by the deposition of IgA in the glomeruli, leading to inflammation and potential damage. It is the most common primary glomerulonephritis worldwide. […] The most common sign in patients with IgA nephropathy is blood in the urine. […] The most common clinical manifestation of IgA nephropathy is microscopic or gross hematuria. Hematuria is often recurrent and may follow upper respiratory tract or other infections. The presence of blood in the urine may be episodic and can vary in severity. […] Proteinuria is another key feature of IgA nephropathy. It may range from mild to moderate and, in some cases, can even progress to nephrotic-range proteinuria. The level of proteinuria is an important indicator of disease severity and prognosis. Persistent and significant proteinuria may be associated with an increased risk for progression to chronic kidney disease.
#24 Immunoglobulin A Nephropathy: 5 Things to Know | MDedge
https://blogs.the-hospitalist.org/content/immunoglobulin-nephropathy-5-things-know
Progressive kidney dysfunction can occur in some individuals with IgA nephropathy. This may manifest as a gradual decline in glomerular filtration rate, leading to chronic kidney disease over time. In addition, up to 20% of patients progress to end-stage kidney disease within 10 years. The risk for renal impairment varies among individuals, and certain clinical and histologic features may influence the prognosis. […] Hypertension is a common complication of IgA nephropathy. The mechanisms underlying hypertension in IgA nephropathy are complex and may involve alterations in the renin-angiotensin-aldosterone system and salt-water balance. Controlling blood pressure is important in managing IgA nephropathy to help slow the progression of kidney damage.
#25 Berger Disease As A Kidney Disease – HealthTree for Kidney Disease
https://healthtree.org/kidney-disease/community/articles/iga-nephropathy-berger-disease-as-a-kidney-disease
If the disease progresses, you may experience the following symptoms: Brown or tea-colored urine. This color change may be noticeable after an infection. Blood in the urine. Foamy urine. This is caused by protein leaking into the urine. Pain on one or both sides of the back, below the ribs. Swelling of the hands or feet. High blood pressure. […] Berger Disease can lead to kidney failure. If so, you may notice the following: itchy skin, muscle cramps, nausea and vomiting, less appetite, metallic taste in the mouth, confusion. […] IgA nephropathy is a life-long disease. It affects millions of people worldwide. Up to 70% of people can experience a normal life expectancy without any complications. […] Theres no cure for IgA nephropathy and no standard way of treating it. Some people wont need treatment at all. Theyll still need to go in for regular checkups to check their kidney function. For others, treatment is aimed at slowing the progress of the condition and managing blood pressure, swelling, and protein levels in the urine. […] The goal of treatment is to manage symptoms and prevent kidney failure.