Alternate Names: Nephropathy - IgA; Berger's disease

Causes and Risks: IgA nephropathy (Berger’s disease) is a form of mesangial proliferative nephritis. Inflammation of the renal glomeruli occurs, and there are IgA (a type of antibody) deposits in the kidney. The disorder can appear as acute, rapidly progressive, or chronic glomerulonephritis; or as visible or microscopic hematuria (blood in the urine).

Berger’s disease usually is discovered after one or more episodes of dark or bloody urine in a person with no other symptoms of kidney disorder. Bloody urine may begin during or soon after a respiratory infection. Although acute nephritic syndrome or nephrotic syndrome (groups of symptoms associated with decreased kidney functioning) may be present, the disorder usually does not permanently affect kidney function. On rare occasions it may progress to chronic renal failure.

Risk factors include having a personal or family history of IgA nephropathy or Henoch Schonlein purpura (a form of vasculitis that affects many parts of the body, and may cause a kidney lesion that is identical to the lesion of Berger’s disease).

Berger’s disease can occur in persons of all ages, but most often affects males in their teens to late 30s.

Prevention: There is no prevention known.

Symptoms:

• changes in color of urine
  • bloody
  • urine dark, brown, or rust colored
• repeated episodes of dark or bloody urine

Signs and Tests: There are no specific changes on physical examination. Occasionally, blood pressure may be elevated or swelling (edema) of the body may be present.

• Urinalysis shows blood and red cell casts in the urine, and may also show protein and fats.
• Kidney biopsy shows deposits of IgA antibodies and confirms the diagnosis.
• Immunoelectrophoresis - urine shows antibodies to IgA.

Treatment: The goal of treatment is to relieve symptoms and prevent or delay of chronic renal failure.

Antihypertensive medications and diuretics may be given to control high blood pressure and edema. Control of blood pressure is the most important measure to delay renal damage. Sodium (salt) and fluids may be restricted to control swelling. Low to moderate protein diet may be recommended in some cases.

Support Groups: The stress of illness can often be helped by joining a support group where members share common experiences and problems. For this condition, see kidney disease - support group.

Prognosis: IgA nephropathy progresses slowly. In many cases, it does not progress at all. High blood pressure, large quantities of protein in the urine, and increased BUN or creatinine levels (blood tests that reflect kidney functioning) indicate a higher risk for progression of the disorder. About 25% of people with IgA nephropathy develop end-stage renal failure within about 25 years.

Complications:

• chronic renal failure
• end-stage renal disease

Call your health care provider if bloody urine develops or if urine output decreases.