IgA Nephropathy: A Leading Cause of Chronic Kidney Disease

About 1 in 7 U.S. adults has chronic kidney disease (CKD), roughly 37 million people. Nearly 9 out of 10 of them do not know it.

Chronic kidney disease (CKD) means the kidneys have lasting damage or are losing their ability to filter the blood. The biggest drivers are diabetes, high blood pressure, and getting older, but in younger adults it’s IgA nephropathy (IgAN).

IgAN is the most common disease of the kidney’s filters worldwide, and a leading cause of CKD and kidney failure. In IgAN, an antibody called IgA builds up in the kidney’s tiny filters and slowly damages them. About 200,000 people in the U.S. are living with IgAN. It is usually found between ages 20 and 40. The encouraging news: when IgAN is found early and treated, you have real power to protect your kidneys.

Who is at higher risk, and why?

Asian American Community

In a large California health system, Asian and Pacific Islander adults were diagnosed with IgAN nearly 4 times as often as White adults. Scientists have found many gene variants linked to IgAN, some seen only in East Asian populations. At diagnosis, Asian and Pacific Islander patients also tended to have more protein in the urine, a sign of more active disease. Worldwide, IgAN is more common in East Asia than in Europe or Africa, and patients of Pacific-Asian background may progress faster.

Hispanic American Community

Hispanic adults were diagnosed with IgAN about 1.5 times as often as White adults and had high protein levels at diagnosis. In one U.S. study, Hispanic patients with IgAN reached kidney failure at the youngest age of any group, around age 46.

African American Community

IgAN is less common in Black adults, but Black patients with IgAN had the highest blood pressure at diagnosis, and Black Americans face a higher risk of CKD overall from other causes.

What are some signs and symptoms of IgAN?

IgAN can range from blood in the urine that you can’t see, to disease that damages the kidneys quickly. That is why a simple urine test is so powerful. Signs to watch for include:

Pink, red, or brown urine, sometimes right after a cold or sore throat
Foamy or bubbly urine, a sign of protein leaking out
High blood pressure
Swelling in the legs, ankles, or around the eyes
Feeling tired as kidney function drops

What happens if IgAN is not found or not treated?

In a diverse U.S. study, more than 1 in 3 IgAN patients lost at least half of their kidney function, reached kidney failure, or died within about 3 years, and 1 in 6 reached kidney failure. Many U.S. patients are diagnosed late, when kidney function is already reduced.

Without treatment, IgAN can lead to:

Kidney failure, which requires dialysis or a transplant to live
Heart disease and stroke, because CKD strains the heart and blood vessels
Kidney failure at a young age

How to prevent CKD, or keep it from getting worse?

There is no known way to prevent IgAN itself, because genes and the immune system drive it. But there is a lot you can do to prevent the kidney damage and CKD it causes, and to protect your kidneys from other causes too.

For everyone:

Get a urine test. A simple urine test can find blood or protein long before you feel sick. Ask for one at your yearly checkup, especially if kidney disease runs in your family.
Know your blood pressure and keep it in your target range.
Cut back on salt. Guidelines suggest less than 2 grams of sodium a day for people with CKD.
Move your body. Aim for at least 150 minutes of moderate activity each week, as your health allows.
Keep a healthy weight and don’t use tobacco.

If you have IgAN:

Work with a kidney doctor (nephrologist). A kidney biopsy confirms the diagnosis.
Aim to bring protein in your urine below 0.5 grams a day, and ideally below 0.3 grams; this is the new goal in the 2025 international guideline.
Ask about kidney-protecting medicines. Guidelines now treat both the immune process behind IgAN and the kidney damage it causes. Several newer medicines made just for IgAN have become available in recent years.
Take your medicines every day, even when you feel fine, and keep every follow-up visit.

Together, we can keep IgAN from becoming kidney failure.

Connect with a patient advocate

Anita

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