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IgA Nephropathy

John Feehally

University Hospitals of Leicester
Leicester, UK

MAY 11th - Symposium 9 - HALL A4/5 16:30 - 18:00

IgA nephropathy is one of the commonest kidney diseases and can cause kidney failure, especially in young adults.  It is called IgA nephropathy because IgA, one type of antibody which is part of our normal defence against infection, fixes in the kidneys resulting in inflammation and damage.
Only a minority of people with IgA nephropathy develop kidney failure, and we can usually predict this by finding increasing amounts of protein in the urine and high blood pressure.
The best way to treat IgA nephropathy has been controversial.  Unfortunately we do not yet understand the exact mechanisms by which IgA damages the kidneys so we cannot design specific treatments to prevent this. Use of medication to alter the patient’s immune system (for example steroid treatment) has not been proven to work in IgA nephropathy and has side effects.
But we now know that very tight control of blood pressure can slow down progressive kidney damage in IgA nephropathy [and in many other progressive kidney diseases], especially if the amount of protein in the urine can be reduced to a minimum.  Medication such as ACE inhibitors and angiotensin receptor blockers are particularly important because of their additional affect in reducing protein in the urine as well as controlling blood pressure.
These straightforward treatments with few side-effects are now making a major difference to the outlook for many people with IgA nephropathy.  They slow down the rate at which the kidneys get worse, and in some [but not all] people they completely prevent kidney failure.