iga nephropathy is a disease associated
with the kidneys which are two
bean-shaped organs in our body that
filter out toxic waste products
and excess water from blood and excrete
them in the urine
now inside each kidney there are
clusters of capillaries
that is tiny blood vessels called
glomeruli
which act like filters of the kidney to
let water and the harmful wastes
through while keeping important things
like red blood cells and proteins
in iga nephropathy is caused by an
abnormal form of iga
a type of immunoglobulin also called an
antibody
normally this is a type of protein that
helps the body fight against bacteria
and other foreign organisms
when the iga has an abnormal structure
it can accumulate in the kidneys
causing inflammation and damage
now because of the glomerular injury red
blood cells leak into the urine
causing hematuria the amount of blood
sometimes is enough to cause reddish or
blackish discoloration of the urine
protein leaking into the urine causes
proteinuria
and may make the urine appear foamy
frequently iga nephropathy presents in
children or young adults as either
microscopic or visible hematuria
meaning that it can be seen under a
microscope or with the naked eye
and it typically develops during an
infection involving the mucosal lining
like infections of the gastrointestinal
or respiratory tract
in these sorts of infections the
production of the abnormal iga antibody
gets ramped up
leading to more accumulation in the
glomerulus causing inflammation and
injury with each mucosal infection
the glomeruli undergo more injury so
over time sometimes decades individuals
may progress
to renal failure
renal failure means decreased kidney
function which may cause
less formation of urine and building up
of excess water in the circulation
this leads to high blood pressure which
can damage other organs like the brain
and heart in addition the protein lost
in the urine
normally helps water stay in the blood
vessels
with less protein in the blood water
starts moving
out of the blood vessels and into the
tissues causing puffiness
or edema mainly in the face and the legs
now in iga nephropathy for some unknown
reason our body starts producing
abnormal iga proteins that the body
recognizes as
foreign the exact reason behind
production of the abnormal iga molecules
is yet to be known but there is some
evidence to suggest that genetic factors
play a role in this disease
it's been suggested that iga nephropathy
is a complex polygenic disease
meaning that there are many genes along
with triggering environmental factors
that contribute to an individual
developing the condition
whatever the cause the result is that
our immune system
attacks these antibodies which leads to
the formation of clusters of proteins
called immune complexes these immune
complexes then travel through the
bloodstream and get trapped at sites of
filtration
like the glomeruli in the kidney iga
protein
immune complexes deposit primarily in
the central area of the glomerulus
known as the mesangial area which is the
tissue that offers structural support to
the glomerular capillaries
once these immune complexes start
depositing they trigger inflammatory
reactions at the site
which ultimately lead to permanent
glomerular damage
which may eventually lead to kidney
failure
diagnosis is suspected based on patient
history
and the signs and symptoms of kidney
disease like bloody or dark urine
following a throat infection with cough
and puffiness of the face and legs
some clinical tests like urinalysis can
check the urine for elevated levels of
red blood cells and protein
blood tests can detect increased levels
of waste products like creatinine
and decreased levels of red blood cells
and protein
at present the definitive diagnosis
requires a kidney biopsy
that shows iga in the glomeruli that can
be seen with the help
of immunofluorescence microscopy
material consistent with immune
complexes in these areas
may be seen on electron microscopy
once the kidneys have been damaged they
can't be repaired
so treatment is mainly focused on
preventing further damage
and avoiding end-stage kidney disease
this can be done two ways
non-immunosuppressive medications that
reduce
blood pressure and scarring in the
glomeruli specifically ace inhibitors
and angiotensin receptor blockers or
arbs
are the cornerstone of treatment these
medications help by reducing the
pressure of blood flowing into the
kidneys
and decreasing the amount of
inflammatory damage in the glomeruli
as a result the amount of blood proteins
lost into the urine
usually decreases reducing the amount of
proteinuria slows progression of the
disease
immunosuppressive medications like
corticosteroids for example prednisone
can reduce the inflammatory damage in
the glomeruli
but due to potential serious side
effects like infection
such treatment is reserved for patients
with severe inflammatory damage
and rapidly declining kidney function
alright as a quick recap iga nephropathy
is a kidney disease which affects the
glomeruli causing leakage of red blood
cells and blood proteins
into the urine the kidney damage may
cause bloody or dark
urine puffiness of the face and the legs
and
high blood pressure in some cases with
degraded kidney function
diagnosis is suspected based on patient
history and clinical tests
and it's established by kidney biopsy
treatment includes medications like
non-immunosuppressive therapy
with ace inhibitors or arbs to control
pressure
and reduce proteinuria and thus delay
progression of the disease
and rarely immunosuppressive therapy
such as corticosteroids
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