Living with immunoglobulin A nephropathy (IgAN) can involve being mindful of what you eat and how you feel. While you might have to make a few changes after an IgAN diagnosis, you may need to adjust your routine again as related conditions develop. Learning about these related conditions can help you spot possible issues early and work with your doctor to protect your kidney health.

Conditions related to IgAN might trigger chronic kidney disease or appear later as a complication of IgAN. A condition that exists alongside another health condition is called a comorbidity. The results of one study indicate that more than 85 percent of people with IgAN live with comorbidities, so it’s likely that you do, too.

In this article, we discuss four conditions related to IgA nephropathy, including comorbidities, complications, and diseases that trigger IgAN.

1. Hypertension

Hypertension (high blood pressure) commonly appears as a complication of IgAN because of reduced kidney function. It’s one of the most common IgAN comorbidities, affecting almost 40 percent of participants with IgAN in one study.

When you have IgAN, a protein called immunoglobulin A from your immune system builds up in your glomeruli (structures in your kidneys that filter your blood). The built-up proteins, called immune complexes, damage your kidneys so they can no longer filter your blood properly. Your kidneys typically keep your blood pressure in balance, but they can’t do so as well when they’re damaged.

High blood pressure can then cause even more damage to your kidneys, which is why many IgAN treatments focus on lowering blood pressure to slow kidney disease progression.

How Is Hypertension Treated?

Many IgAN treatments focus on keeping your blood pressure within a healthy range to prevent further kidney damage. If you have high blood pressure with IgAN, your healthcare provider may recommend changing your lifestyle to avoid habits that keep blood pressure high, like smoking or eating too much sodium (salt).

Certain medications commonly prescribed for IgAN also help treat hypertension. Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) both help lower blood pressure in addition to reducing proteinuria (protein in your urine). Doctors may also use sodium-glucose cotransporter 2 (SGLT2) inhibitors to protect your kidneys and reduce urine protein as part of managing blood pressure in IgAN.

2. Cirrhosis

Liver diseases are the most common causes of secondary IgA nephropathy, which is IgA nephropathy triggered by another medical condition. This includes cirrhosis, which is scarring on the liver that prevents the liver from functioning normally.

There are several common causes of cirrhosis:

• Long-term heavy alcohol use (called alcoholic cirrhosis)
• Viral hepatitis (hepatitis B and C)
• Autoimmune hepatitis
• Primary biliary cholangitis
• Metals, like iron or copper, building up in the liver
• Side effects of specific medications, including methotrexate

Cirrhosis can cause IgAN because the liver usually plays a role in clearing immune complexes. When the liver can’t do this job properly, those complexes are more likely to build up in the glomeruli and cause kidney damage.

How Is Cirrhosis Treated?

When cirrhosis and IgA nephropathy occur together, treatment focuses on the underlying liver disease. For example, alcoholic cirrhosis treatment involves avoiding alcohol (which might require going through a treatment program for alcohol dependency).

If you have cirrhosis from hepatitis B or hepatitis C, your doctor may prescribe antiviral medications to treat the underlying viral hepatitis.

3. Celiac Disease

You might know celiac disease as the condition that prevents many people from being able to eat foods with gluten, a protein from rye, barley, and wheat. It’s an autoimmune disease, so eating gluten triggers a response from your immune system in the digestive system that can lead to the following symptoms:

• Stomach pain and bloating
• Diarrhea
• Anemia symptoms like fatigue and pale skin
• Malnutrition
• An itchy skin rash

It’s common for people with IgAN to have celiac disease, too. People with celiac disease are three times more likely to develop IgAN than people without celiac disease and are at a higher risk for end-stage renal disease (also called kidney failure).

Like celiac disease, IgAN originates in the immune system, with antibodies building up and getting stuck in your kidneys. Autoimmune diseases usually appear in clusters, so it’s common to have more than one at the same time.

How Is Celiac Disease Treated?

If you have celiac disease and IgAN, and especially if you have digestive symptoms like bloating and diarrhea, your doctor will likely tell you to avoid eating foods that contain gluten.

A gluten-free diet for someone with celiac disease excludes foods you would expect, like bread and pasta, as well as foods with gluten that’s a little more hidden, like prepackaged sauces and soups.

Talk to your doctor or dietitian about navigating a kidney-friendly diet that also excludes gluten if you have celiac disease with IgAN.

4. Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a major risk factor for IgA nephropathy, making it another related condition. There are two types of IBD, ulcerative colitis (UC) and Crohn’s disease, and both are strongly associated with IgAN.

Like celiac disease, IBD affects the gastrointestinal (GI) tract. Both UC and Crohn’s disease cause inflammation and sores in the GI tract, with UC mainly affecting the large intestine and Crohn’s affecting any part of the GI tract, including the mouth and small intestine.

Researchers are still studying the connection between IgAN and IBD, but they believe the conditions may be connected because many IgA antibodies are produced in the GI tract. Inflammation in the area might increase the production of antibodies, making them more likely to build up into immune complexes in the kidneys. This might explain why people with IBD and IgAN are at a higher risk of end-stage kidney disease.

Specific cytokines (signaling molecules) in the immune system appear to cause inflammation in both conditions, and they appear to share some genetic links, too.

How Is IBD Treated?

Researchers are studying whether treatments for IBD could improve the outlook of people with IgAN.

Treatment for IBD depends on which type you have, but most medications, such as immunosuppressive medications, aim to reduce immune system activity or inflammation. Many treatment options for IgAN serve the same purpose.

Short-term corticosteroids, for example, can help reduce proteinuria in some people with IgAN. They’re also commonly used to treat inflammation during IBD flare-ups.

The Importance of Regular Monitoring

Whether or not you currently have comorbidities with IgAN, your doctor or nephrologist will want to monitor you for changes in your IgAN as well as signs of related conditions. They may recommend regular:

• Blood pressure readings — Checking your blood pressure helps you find out if you have hypertension or are at risk.
• Liver function tests — Since cirrhosis and other liver diseases are the most common causes of secondary IgAN, your doctor may want to monitor your liver health closely, especially with risk factors like heavy alcohol use.
• Management of existing conditions — Managing your related conditions may help improve your IgAN and prevent more complications.

Steps like these don’t just help you track your health. They can also help protect your kidney function and slow the progression of IgAN to end-stage kidney disease.

Talk to your doctor about how to safely manage your IgAN along with any related conditions you have.

Join the Conversation

On myIgANteam, people share their experiences with IgA nephropathy, get advice, and find support from others who understand.

Which conditions do you have that are related to your IgA nephropathy? Let others know in the comments below.