Summary about Disease
Berger's disease, also known as IgA nephropathy, is a kidney disease that occurs when an antibody called immunoglobulin A (IgA) builds up in your kidneys. This buildup results in local inflammation that, over time, can hamper your kidneys' ability to filter waste from your blood. It is a slowly progressing disease, but the course of the disease varies significantly from person to person. Some people experience complete remission, while others develop end-stage renal disease (ESRD).
Symptoms
Hematuria (blood in the urine): This is often the first noticeable symptom, and it may be macroscopic (visible) or microscopic (detectable only with a urine test). Hematuria may be episodic, often occurring after an upper respiratory infection, exercise, or menstruation.
Proteinuria (protein in the urine): This can be detected on a urine test and may indicate kidney damage.
Foamy urine: Can also be a sign of protein in the urine.
Swelling (edema): Can occur in the hands, feet, ankles, and around the eyes.
High blood pressure (hypertension): Can develop as kidney function declines.
Flank pain: Pain in the side or back may occur, though it's less common.
Causes
The exact cause of Berger's disease isn't fully understood, but it's believed to involve a combination of:
Genetic predisposition: The disease tends to run in families, suggesting a genetic component.
Immune system dysfunction: The body produces an abnormal form of IgA (galactose-deficient IgA1 or Gd-IgA1). The body then produces antibodies against this abnormal IgA, forming immune complexes that deposit in the kidneys.
Environmental triggers: Infections (especially upper respiratory infections), certain medications, and certain foods may trigger or worsen the condition.
Medicine Used
Treatment focuses on slowing the progression of the disease and managing symptoms. Medications may include:
ACE inhibitors or ARBs: These medications help lower blood pressure and reduce protein in the urine. Examples include lisinopril, enalapril, losartan, and valsartan.
Corticosteroids: Such as prednisone, may be used to suppress the immune system and reduce inflammation, but their use is carefully considered due to potential side effects.
Immunosuppressants: Other immunosuppressant medications, such as azathioprine or mycophenolate mofetil, may be used in certain cases.
Omega-3 fatty acids: Found in fish oil, may help reduce inflammation.
Statins: To manage cholesterol levels, which can be affected by kidney disease.
SGLT2 inhibitors: such as dapagliflozin and empagliflozin, have demonstrated benefits in slowing kidney disease progression.
Endothelin receptor antagonists (ERAs): sparsentan is approved for proteinuria reduction in IgAN.
Is Communicable
No, Berger's disease is not communicable or contagious. It is not caused by an infection and cannot be spread from person to person.
Precautions
Manage blood pressure: Keep blood pressure under control, often with medication and lifestyle changes.
Reduce protein intake: May help reduce the workload on the kidneys. Consult with a registered dietitian.
Limit salt intake: Helps control blood pressure and edema.
Maintain a healthy weight: Obesity can worsen kidney disease.
Avoid NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can damage the kidneys.
Regular checkups: Regular monitoring of kidney function with blood and urine tests is crucial.
Quit smoking: Smoking can worsen kidney disease.
Manage other health conditions: Control diabetes and high cholesterol.
How long does an outbreak last?
The "outbreak" refers to the episodes of hematuria. These episodes often correlate with infections (e.g., upper respiratory infections) or other triggers. A single episode of visible hematuria might last from a few days to a week or two. However, the underlying kidney disease (IgA nephropathy) is a chronic condition, not a short-term "outbreak.
How is it diagnosed?
Urine tests: To check for blood and protein in the urine.
Blood tests: To assess kidney function (creatinine, BUN), electrolyte levels, and IgA levels.
Kidney biopsy: This is the definitive diagnostic test. A small sample of kidney tissue is examined under a microscope to look for IgA deposits.
Physical Exam: To assess overall health and look for signs of edema or high blood pressure.
Imaging Tests: Such as ultrasound, to evaluate the structure of the kidneys.
Timeline of Symptoms
Berger's disease can progress slowly, and the timeline of symptoms varies greatly.
Early stages: May be asymptomatic or have only microscopic hematuria. This may be discovered incidentally during a routine urine test.
Later stages: Episodes of visible hematuria become more frequent. Proteinuria may develop. High blood pressure and edema may appear.
Advanced stages: Kidney function progressively declines, leading to chronic kidney disease and potentially end-stage renal disease (ESRD), requiring dialysis or kidney transplantation. The time from diagnosis to ESRD can range from years to decades, or may not occur at all.
Important Considerations
Progression varies: The course of Berger's disease is unpredictable. Some individuals experience stable kidney function for many years, while others progress more rapidly.
Pregnancy: Berger's disease can affect pregnancy. It's crucial to discuss family planning with a nephrologist.
Lifestyle changes: Adopting a healthy lifestyle, including diet and exercise, is important for managing the disease.
Psychological impact: Living with a chronic kidney disease can be emotionally challenging. Seek support from family, friends, or a therapist.
Regular monitoring: It is essential to have regular follow-up appointments with a nephrologist to monitor kidney function and adjust treatment as needed.
Clinical trials: Consider participating in clinical trials to contribute to research and potentially gain access to new treatments.