WHAT IS IgA NEPHROPATHY (IgAN)?
IgAN is a rare kidney disease
IgAN is a leading cause of kidney failure. Loss of kidney function is permanent and may result in dialysis or transplant.
Even if you don’t have symptoms, IgAN should not be ignored. Once IgAN causes damage to the kidneys, the damage is permanent.
Not actual patients.
The kidneys filter the blood in your body
They get rid of waste products from your blood, remove extra fluid from your body through your urine, and let proteins and other nutrients return to your bloodstream.
IgAN causes damage to the filters in your kidneys, letting increased amounts of protein spill from your blood into the urine. This is called proteinuria.
Your proteinuria level is one indicator that can help you and your doctor understand your kidneys’ health. Higher levels of proteinuria are considered a major risk factor for disease worsening and loss of kidney function. It is important to monitor and treat proteinuria to preserve kidney function.
PROTEINURIA
A closer look at proteinuria
Proteinuria
(pro-teen-yur-ee-uh)
Some people with IgAN can have higher levels of proteinuria than others.
Proteinuria can be detected in a urine test. Sometimes, heavy amounts of protein appear as foamy urine, a key potential sign to look out for.
Why is it important to monitor your proteinuria?
Elevated levels of protein in your urine may indicate your kidneys’ filters have been damaged. If you have consistently elevated proteinuria, your doctor may recommend medication—typically a blood pressure medicine known as an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB)—as your foundational treatment for managing IgAN.
Blood pressure medicines may not be enough to reduce your proteinuria and keep urine protein levels low.
Routinely monitoring your proteinuria can help you and your doctor make important decisions regarding your disease management. Together with your doctor, be sure to discuss your treatment goals.
What is a recommended proteinuria goal?
Protein levels are measured in the urine in grams per day (g/d).
IgAN guidelines suggest that keeping proteinuria below 1 g/d will lower the risk of disease progression. But that may not be enough. To help protect your kidneys, it’s vital to lower proteinuria below 0.3 g/d.
Proteinuria below 0.3 g/d is considered complete proteinuria remission. It occurs when you have little to no protein detected in your urine.
KIDNEY DAMAGE
How does proteinuria damage your kidneys?
IgAN occurs when immunoglobulin A (IgA)—an antibody in your blood that helps fight infections—builds up in your kidneys and disrupts their ability to filter waste from the blood. A number of undesirable processes involving endothelin-1 (ET-1) and angiotensin II (Ang II) take place in the kidneys, weakening the filters.
ET-1 and Ang II play a key role in 2 pathways in the kidneys that are known to create a harmful cycle with proteinuria:
- They increase each other’s activity, resulting in more proteinuria
- More proteinuria may lead to more ET-1 and Ang II, resulting in further kidney damage
The sooner you lower your proteinuria, and keep it low, the longer you may be able to maintain your kidney function.
SYMPTOMS
Symptoms and signs of IgAN
Not everyone experiences symptoms with IgAN at first. In fact, up to 40% of people living with IgAN have no recognizable symptoms when their disease is first suspected. People can have this disease for years without knowing it as it continues to progress. Symptoms and signs of IgAN can include:
- Protein in your urine (proteinuria), which can sometimes make your urine appear foamy
- Blood in your urine (hematuria), which can sometimes be visible and make your urine appear dark brown or tea-colored
- Pain in one or both sides of your back, below your ribs
- High blood pressure
- Swelling (edema) in your feet, ankles, or sometimes eyelids
- Fatigue
Because IgAN can get worse over time, it's important for you and your doctor to routinely monitor your condition.
TEST RESULTS
What test results (your “numbers”) mean—and why they matter
If you have IgAN, your doctor will perform tests to learn more about your kidneys. Routine, ongoing tests could include urine and blood tests to measure your proteinuria and kidney function and to monitor the results over time.
Proteinuria
Proteinuria is measured in grams per day through a urine test. A person with proteinuria has a higher amount of protein in their urine than normal. Elevated levels of protein in your urine may indicate your kidneys’ filters have been damaged. In IgAN, high proteinuria is considered a major risk factor for disease worsening, and is important to monitor.
eGFR
IgAN damages structures within the kidneys that filter your body’s blood, known as the glomeruli. This damage is permanent and can lead to loss of kidney function. Your eGFR, or estimated glomerular filtration rate, helps estimate how well your kidneys are working to remove waste products from the blood. It is determined through a blood test.
Your eGFR is routinely tracked over time to gauge changes and understand any decline in kidney function that may be happening. Normal results range from 90 to 120 mL/min/1.73 m2. As your kidney function worsens, your number lowers. An eGFR below 15 mL/min/1.73 m2 is a sign of kidney failure. Proper treatment may slow the decline in kidney function loss.
Blood pressure
Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body.
Your kidneys play a part in balancing your blood pressure. When kidneys are damaged by IgAN, it becomes difficult for them to continue maintaining this balance. This results in higher blood pressure values. High blood pressure can further damage your kidneys.
FILSPARI® is not indicated to lower blood pressure.
Don’t wait to talk to your doctor about your proteinuria levels
Even if your proteinuria is lower than 1 g/d, you should still take it seriously. Any elevated level of protein in the urine could be causing permanent kidney damage. It's crucial to upgrade to a treatment that can powerfully lower proteinuria and preserve kidney function.
Consult with your doctor and ask if your treatment is right for where you are currently. Don’t be afraid to speak openly and ask questions. Together, you and your doctor can stay on top of changes in your condition and treat it in the best way possible.