When the kidneys aren’t working well, diabetes and high blood pressure often get the blame — and for good reason. They’re two common causes of kidney problems. But they aren’t the only ones.

People with immunoglobulin A nephropathy (IgAN), a type of chronic kidney disease (CKD), develop kidney damage when IgA, a type of antibody, builds up in the filters in the kidneys.

Normally, IgA antibodies help the body fight germs. In IgAN, these antibodies can collect in the kidneys and trigger inflammation, which gradually damages the kidneys. Certain medications, infections, inflammation in the body, and everyday habits can also worsen kidney damage in people with IgAN.

The term renal dysfunction combines renal, which means kidneys, and dysfunction, which means poor function. In other words, it means the kidneys aren’t working well. Understanding these hidden causes of renal dysfunction can help people with IgAN spot warning signs earlier, ask better questions, and take steps to protect their kidneys.

What Is Renal Dysfunction?

In IgAN, IgA builds up in the kidneys’ tiny filters. These deposits cause inflammation and can lead to lasting kidney damage so the kidneys can’t work properly, leading to renal dysfunction. Up to 50 percent of people with IgAN eventually develop kidney failure. If that happens, they may need dialysis or a kidney transplant.

Factors That Can Worsen Kidney Function in IgAN

People with IgAN can have worsening kidney function because of other health conditions, lifestyle habits, or certain medications. Knowing about these lesser-known causes can help you spot problems early, even if your doctor doesn’t catch them right away.

Delayed Diagnosis and Treatment

Unfortunately, people don’t always realize they have IgAN until several years have passed. This is because the disease usually doesn’t have obvious symptoms until the condition has progressed. IgA nephropathy can quietly worsen kidney function if the disease continues, especially without treatment. Getting diagnosed and starting treatment as early as possible can help slow how quickly IgAN progresses to renal failure.

Inflammation

Ongoing inflammation from IgA nephropathy can make kidney function worse over time. When IgA antibodies build up in the kidneys, they trigger the immune system to stay active. This constant immune response can damage the kidney filters, making it harder for the kidneys to remove waste and extra fluid from the body.

Flare-ups of inflammation may happen during or after infections, such as colds, flu, or stomach bugs. Managing IgAN with the right treatment plan and addressing infections promptly can help limit ongoing kidney damage.

Infections

Research suggests that people with IgAN have higher rates of infections than those without the condition. Infections can put extra stress on the kidneys in people with IgAN and trigger immune responses that increase inflammation in the kidneys.

The types of infections most associated with IgAN include:

• Urinary tract infections
• Infections of the muscles, bones, and connective tissue
• Ear, nose, and throat infections
• Infections of the gastrointestinal tract

Some people with IgAN notice blood in their urine or worsening symptoms after an infection. Treating infections early and letting your care team know if symptoms change can help protect kidney function.

Certain Medications

People with CKD need to be especially careful with certain medications. Some medications can harm the kidneys or make existing kidney damage worse. Nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen, are a common example. These drugs are often used for pain or inflammation, but they can reduce blood flow to the kidneys and cause damage.

Certain medications used to treat other health conditions, like diabetes and hypertension (high blood pressure), may worsen kidney problems. Other medications, like some antibiotics, antacids, and blood thinners, can also harm the kidneys or have side effects due to buildup in the body. In addition to medications, contrast dyes used in imaging tests can also affect kidney function.

Always talk to your healthcare provider before starting a new medication, even one you can buy over the counter. If you have multiple health conditions, work with your healthcare provider to come up with a treatment plan that is safe for your kidneys.

Your healthcare provider can help decide if you should adjust your dose or take a different form of medicine, depending on your level of kidney function. This is measured with a blood test called the estimated glomerular filtration rate (eGFR). Once they know how well your kidneys function, your healthcare team can plan the best way to balance the risks and benefits of different medications.

High Blood Pressure

Hypertension, which is common in people with IgAN, can speed up kidney damage. Damaged kidneys also make it harder to control blood pressure, creating a harmful cycle. Eating too much salt can increase blood pressure, which puts added strain on the kidneys.

Monitoring blood pressure and taking prescribed medications as directed can help slow the progression of kidney disease in people with IgAN. Your doctor may recommend limiting your salt intake or making other dietary changes. A kidney-friendly diet doesn’t look the same for everyone with IgAN. A doctor or dietitian can help you understand what foods may be best for your specific situation.

Preventing Renal Dysfunction

As research uncovers new information about the factors linked to IgAN, screening and diagnosis may happen faster and more often. Once you’re diagnosed with IgAN, you can make choices that help protect your kidneys from damage.

Proteinuria (protein in the urine) is a key sign of kidney damage and disease progression in IgAN. When the kidneys are healthy, they’re able to filter the blood to keep protein and red blood cells from getting out into the urine. But in people with CKD, the kidneys don’t filter as well. As a result, albumin (a protein normally found in the blood) and red blood cells can leak into the urine.

Your healthcare provider should check your urine protein levels regularly. If the levels go up, they may suggest changes to help protect your kidneys. Lifestyle changes and certain medications can help slow further kidney damage.

Lifestyle Changes

People with IgAN can make healthy choices to help slow down renal disease, including:

• Managing blood pressure
• Limiting sodium intake
• Quitting smoking
• Participating in daily exercise

Medication

Some of the medications used to slow the progression of IgAN include:

• Angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers to lower blood pressure
• SGLT2 inhibitors and endothelin receptor antagonists to reduce the level of protein in the urine
• Steroids and complement factor B inhibitors to calm the immune system and reduce inflammation
• A monoclonal antibody that blocks a cytokine called APRIL to prevent the production of faulty IgA antibodies

Renal dysfunction in IgAN isn’t caused by just one factor. Infections, inflammation, certain medications, and everyday habits can all affect how well your kidneys work. Knowing what can make kidney damage worse can help you protect your kidneys and slow renal disease. New treatments for IgAN are also being developed. A nephrologist (kidney specialist) can help you learn about the latest options and decide what may work best for you.

Join the Conversation

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

How did you discover the cause of your kidney problems? Let others know in the comments below.