What is Stage 4 IgA Nephropathy?

Understanding Stage 4 IgA Nephropathy: Causes, Signs & Care

Immunoglobulin A nephropathy, or IgA nephropathy, affects how your kidneys function. Also known as Berger’s disease, it leads to a buildup of a germ-fighting protein IgA in your kidneys. This leads to inflammation and slows regular kidney function. There are 5 stages of this disease, with stage 4 being an advanced stage.

Staging IgA Nephropathy

Before understanding stage 4 IgA nephropathy, let us see what each stage entails:

Symptoms of Stage 4 IgA Nephropathy

Since stage 4 is an advanced stage, your body will start showing notable symptoms. They are:

• Foamy urine (Proteinuria)
• Pink urine, caused by blood in your urine (haematuria)
• High blood pressure
• Cola-coloured urine
• Urinating too little or too often
• Oedema or swelling in the hands and feet
• High levels of creatinine in your serum

All of these symptoms occur because your kidneys do not filter waste properly. As a result of waste buildup, your hands and feet swell.

Causes of IgA Nephropathy

Researchers are conducting research on the causes of IgA nephropathy. It could be a combination of genetic or environmental factors. IgA nephropathy is caused by abnormal immune regulation leading to deposition of IgA in the kidneys. Upper respiratory infections may trigger disease flares but are not the root cause.

Your body makes IgA to fight off the cold. However, your immune system may make them in excess. The extra protein deposits in your kidneys cause inflammation and kidney damage.

Diagnosing Stage 4 IgA Nephropathy

If you face any of the above symptoms, immediately visit your doctor. After reviewing your symptoms, they will request several diagnostic tests. These tests are:

• uPCR Test: It measures the amount of protein and creatinine in your urine.
• Urinalysis Test: This test looks for protein or blood in your urine.
• eGFR Test: It is a blood test measuring the functioning of your kidneys. Less than 30 eGFR levels usually indicate stage 4 IgA nephropathy.
• Kidney Biopsy: Doctors remove a small tissue sample from your kidneys to check under a microscope.

Treating Stage 4 IgA Nephropathy

Although IgA nephropathy is not curable, there are several treatments available that can stop its progression to kidney failure. They are:

• SGLT2 inhibitors (e.g., dapagliflozin): Now recommended for CKD with proteinuria.
• Endothelin Receptor [Type A] Antagonists (ERAs): These medicines can relax the blood vessels in your kidneys. It helps in lowering the protein content in your urine. Although it cannot cure the disease, it can slow the process.
• ACE Inhibitors or ARBs: ACE inhibitors or ARBs are first‑line therapy in IgA nephropathy. Certain endothelin receptor antagonists may be added to optimized ACE inhibitor or ARB therapy, depending on the specific drug and clinical context.
• Dialysis: It is a process where a machine manually removes waste from your body when your kidneys fail to do so effectively.
• Kidney Transplant: Your nephrologist replaces your damaged kidney with a healthy donor kidney. However, this does not guarantee a cure. The new kidney may also develop IgA nephropathy.

Living with stage 4 IgA nephropathy can be difficult, but proper care and treatment can help you lead a quality life. Early diagnosis can save your kidneys from being damaged further.

Reader information: This article is intended for general informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Information provided here should not be used as a substitute for professional medical consultation with a qualified healthcare provider or nephrologist. The symptoms, diagnostic methods, and treatment options described may not be appropriate for every individual and can vary based on personal health conditions. Always seek the advice of a licensed medical professional for any questions regarding a medical condition or before starting, changing, or stopping any treatment.

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