Knowing what symptoms to look out for in immunoglobulin A nephropathy (IgAN) can help you recognize the disease and seek treatment sooner. IgAN — also known as Berger’s disease — is a kidney disease that develops when a specific type of antibody known as immunoglobulin A gets stuck in the kidneys. These antibodies form clumps that settle in the kidney’s filtering system, causing damage and irritation.

If left untreated, IgAN can lead to chronic kidney disease, end-stage renal disease (ESRD), and permanent kidney damage. Learn more about the different signs and symptoms of IgA nephropathy.

Symptoms of IgA Nephropathy

Most people with IgAN don’t have any symptoms early in the disease. Over the course of several years to decades, the kidneys slowly become damaged, eventually causing noticeable symptoms. If you begin experiencing one or more of these symptoms, talk with your regular doctor or nephrologist (kidney specialist).

1. Blood in Urine

The most common first symptom of IgAN is hematuria (blood in the urine). Sometimes, hematuria shows up only in a urine test that is sensitive enough to detect a few blood cells. In other cases, the blood is immediately visible, turning the urine pink or brown, similar to the color of cola or tea.

You may notice blood in your urine during or after a respiratory infection, such as a cold, or after intense exercise. When your body is fighting an infection, it ramps up the production of antibodies, including IgA, to help destroy bacteria or viruses. As a result, more IgA antibodies form immune complexes (clumps) and become stuck in your kidneys, causing symptoms.

Your kidneys are made of around 1 million nephrons — small structures that filter your blood. Each nephron has two parts, a glomerulus and a tubule. The glomerulus consists of tiny clusters of blood vessels with thin walls that filter out fluid, waste, and other small substances while leaving proteins and blood cells behind. But when the glomeruli are damaged, blood cells can leak into the urine. Hematuria is a sign of damage to the glomeruli in your kidneys.

2. Foamy Urine

Foamy urine may be caused by too much protein in your urine. This condition is known as proteinuria, and it’s another sign that IgA nephropathy may be damaging your kidneys. Proteins are important building blocks for bones and muscles, and they help your body repair itself. Specifically, the protein albumin may leak from the kidneys. If that’s the case, your doctor or nephrologist may refer to proteinuria as albuminuria.

When your kidneys filter your blood, the protein should stay in a blood vessel that runs alongside the glomeruli. Normally, proteins are too big to pass through the filter and leave the body through your urine. However, in IgAN, these filters become damaged, allowing proteins to leak out. This disease may also damage the kidneys’ tubules, which are responsible for collecting proteins to keep in your body.

If you notice foamy urine along with other symptoms of IgAN, talk to your doctor or nephrologist. They can run a simple test using a dipstick that changes color based on the amount of protein in your urine.

3. Swelling

As IgAN progresses, your kidneys become more damaged and can no longer work as well as they should. You may begin experiencing kidney disease symptoms and, in severe cases, end-stage kidney disease symptoms. One of these is edema (swelling).

Your kidneys help clear out extra fluid from your body through your urine. The tubules in your kidneys collect and return the substances your body needs back into your blood vessels, and the remaining fluid then becomes urine.

In people with IgAN, this process is disrupted. Albumin is important for maintaining your body’s fluid balance — without this protein, your body loses its ability to reabsorb extra fluid. As a result, the extra fluid collects in your feet, ankles, and legs, causing swelling and shiny, tight-feeling skin.

IgAN can also cause you to have puffy eyelids in the morning, due to fluid retention. This is another sign of edema and impaired kidney function.

Your healthcare provider may prescribe a diuretic to help your kidneys filter excess fluid.

4. Urinating More

People with IgAN might notice they’re taking more trips to the bathroom as time goes on. There are a couple of reasons for this change. For one, the kidneys directly affect urination. Both kidney disease and the medications you take to manage it can impact how often you need to pee.

Increased urination is a common side effect of proteinuria. You may pee more often as your body tries to clear out the protein in your urine. In addition, diuretics prescribed to reduce swelling from IgAN work by boosting urination. Let your healthcare provider know about any changes to your urination. They can advise you on how to manage this symptom, which may involve adjusting the timing of your medication and your water intake.

5. Fatigue

It’s common for people with IgAN to feel more tired than they used to. In some cases, fatigue has a significant impact on their quality of life.

There are many possible causes of fatigue. Perhaps you’re tired from the stress of living with IgAN or as a side effect of your medication. If you’re waking up more often at night to use the bathroom, disrupted sleep could be part of the problem. You could also be fighting off an infection.

However, sudden fatigue can also be a sign of kidney failure. If you’re very tired or you’re experiencing other symptoms, like trouble concentrating or peeing a lot, seek medical attention right away.

Talk to Your Doctor About IgA Nephropathy

If you’ve noticed one or more symptoms of IgAN recently, make an appointment to talk to your doctor or nephrologist. They can run some tests to measure your kidney function and make a diagnosis. The sooner you begin treatment, the fewer complications you’re likely to have.

Tests for IgAN include:

• A physical exam to look for swelling and skin changes
• Urine tests to check for blood and protein in your urine
• Blood tests to measure your glomerular filtration rate (GFR), which checks your kidney function
• A kidney biopsy (taking a small piece of kidney tissue to examine under a microscope) to look for IgA deposits

Depending on your symptoms, your doctor or nephrologist will fine-tune your treatment plan and may prescribe medications to:

• Treat high blood pressure
• Remove extra fluid from your body
• Dampen your immune system (using corticosteroids or immunosuppressive medications)
• Reduce high cholesterol levels (using statins)

Join the Conversation

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

How do IgA nephropathy symptoms affect your life? Let others know in the comments below.