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Although there’s no cure for immunoglobulin A nephropathy (IgAN), treatment can help slow kidney damage and protect kidney function.
Managing IgAN often involves several approaches, from controlling blood pressure and taking prescribed medications to making kidney-friendly lifestyle changes. Here are six key ways to help maintain kidney function and slow the progression of IgAN.
IgA nephropathy, also called Berger’s disease, is a chronic kidney disease that affects the kidneys’ filtering units, called glomeruli. In IgAN, IgA antibodies build up in the kidneys and cause inflammation and kidney damage. Over time, this damage can make it harder for the kidneys to remove waste and extra fluid and may cause blood or protein in the urine.
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Without treatment, IgAN can gradually get worse and may eventually lead to kidney failure. Studies suggest that 20 percent to 50 percent of people with IgAN develop kidney failure within 20 years of diagnosis. If this happens, treatment may include dialysis or a kidney transplant.
The good news is that following your treatment plan can help slow kidney damage. The six approaches below focus on protecting kidney function and reducing the risk of IgAN getting worse.
Many people with IgAN have hypertension (high blood pressure) because their kidneys can’t filter out extra fluid from the bloodstream. This increases the amount of blood in the body, raising the pressure inside blood vessels.
High blood pressure also puts extra strain on the delicate blood vessels in the kidneys, causing more damage.
Several medications can help control blood pressure and protect kidney function. Some target angiotensin, a hormone that causes blood vessels to tighten.
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) help relax blood vessels. This action lowers blood pressure and reduces stress on the kidneys.
The U.S. Food and Drug Administration (FDA) has approved dual endothelin-A and angiotensin 2 type-1 receptor antagonists (DEARAs), such as sparsentan (Filspari), for adults with primary IgAN who are at risk of disease progression.
DEARAs work in two ways. Like ACE inhibitors and ARBs, they block angiotensin to lower blood pressure. They also block endothelin, another substance that narrows blood vessels and increases stress on the kidneys. By blocking both pathways, DEARAs slow kidney function decline in adults with primary IgAN at risk for kidney damage.
Certain diabetes medications, called sodium-glucose cotransporter 2 (SGLT2) inhibitors, may also help slow IgAN progression.
SGLT2 inhibitors such as dapagliflozin and empagliflozin have been shown to reduce proteinuria (protein in the urine) — a sign of kidney damage — by about 23 percent to 27 percent within three to six months.
SGLT2 inhibitors may be prescribed together with ACE inhibitors, ARBs, DEARAs, or other IgAN treatments, at the discretion of your healthcare team to best address your individual situation.
Anti-inflammatory medications, such as corticosteroids (steroids) and other immunosuppressants, help reduce inflammation by calming the immune system.
Steroids are laboratory-made hormones that help stop the immune system from attacking the kidneys. These corticosteroids aren’t the same as steroids sometimes used by bodybuilders or athletes.
Your nephrologist may prescribe an oral steroid such as prednisone. The FDA has also approved the steroid budesonide (Tarpeyo) to reduce the loss of kidney function in adults with primary IgAN who are at risk of worsening disease.
In studies, budesonide also lowered protein levels in the urine. Unlike traditional steroids that affect the whole body, this medication is designed to target the immune response linked to IgAN.
Doctors may recommend combining cyclophosphamide with steroids for people whose IgAN is progressing rapidly. Cyclophosphamide is often used as chemotherapy to treat cancer, but it can also treat IgAN by keeping immune cells from growing and dividing.
Targeted therapies suppress specific parts of the immune system to help slow IgAN progression. Below are some currently approved immunosuppressive treatments.
The FDA approved iptacopan (Fabhalta) in 2024 to help lower protein in urine in adults with primary IgAN who are at risk of worsening disease. Iptacopan is a complement inhibitor — it blocks activity in the complement system. The complement system is one part of the immune system that’s involved in kidney injury in IgAN.
In clinical trials, participants took either iptacopan or a placebo (an inactive treatment). Results showed that iptacopan lowered proteinuria significantly more than the placebo.
Atrasentan (Vanrafia) is an endothelin receptor antagonist that targets endothelin A. This medication received FDA approval in 2025 for adults with primary IgAN who are at risk of rapid disease progression. Atrasentan is the first medication of its kind approved to treat IgAN.
Atrasentan can be combined with first-line treatments, such as ACE inhibitors, ARBs, DEARAs, or SGLT2 treatments, at the discretion of physicians.
Sibeprenlimab-szsi (Voyxact) blocks a signal in your body, called APRIL, that directs the production of an abnormal type of IgA that harms the kidneys.
This APRIL inhibitor — also called an anti-APRIL monoclonal antibody — received FDA approval in 2025 to reduce proteinuria in adults who have primary IgAN and are at risk of progression.
Atacicept-vymj (Trutakna) is another targeted therapy that blocks signals that lead to the production of abnormal IgA that harms the kidneys.
This drug blocks a set of signals called APRIL and BAFF. It received accelerated FDA approval in 2026 to help reduce proteinuria in adults with primary IgAN at risk for disease progression.
Atacicept-vymj is an immunosuppressant and may increase the risk of infections and other diseases. Long-term studies haven’t been completed, and people who take this medication should be monitored closely for signs of infection.
To remove excess fluid from your body, your doctor may prescribe a diuretic. Also called water pills, diuretics help the kidneys release sodium to pull more water out of the bloodstream. The extra water leaves the body as urine. You’ll notice you need to urinate more often while taking diuretics.
Water pills help treat swelling caused by IgAN, and they also lower blood pressure. If your kidneys don’t work as well as they should, your doctor may prescribe a diuretic.
IgAN can also affect your cholesterol levels. Long-term inflammation raises low-density lipoprotein (LDL), or “bad” cholesterol. Over time, cholesterol can build up in fatty deposits in your blood vessels, putting you at risk of health problems like a heart attack or stroke.
Your doctor may prescribe a cholesterol-lowering medication like a statin if your levels are too high. Statins reduce how much cholesterol your liver makes and also help your body remove extra cholesterol from the bloodstream.
Changes to your diet can help control blood pressure and cholesterol levels. Limiting salt intake is often the first step. Salt causes your body to hold on to extra water, which can increase your blood pressure.
Processed foods, such as canned products and frozen meals, are often high in sodium. Choosing nutrient-rich whole foods may help reduce inflammation. Try to eat more fresh fruits and vegetables, and cook your meals at home so you can control how much salt you eat.
Some people with advanced IgAN also need to watch their protein intake. Your healthcare provider can recommend the right amount of protein to protect your kidneys while maintaining muscle mass.
If your kidney disease continues to worsen, your doctor may also suggest cutting back on foods high in potassium and phosphorus. These minerals can build up in the blood and cause problems if your kidneys aren’t functioning well.
You may consider working with a registered dietitian to develop an individual plan to make sure you’re getting proper nutrients without aggravating your kidneys.
Your nephrology team is your best source of guidance for managing IgAN. New treatment options continue to become available. Following your treatment plan and making lifestyle changes can help protect your kidneys over time. Taking action early can make a meaningful difference in managing your condition.
On myIgANteam, people share their experiences with IgA nephropathy, get advice, and find support from others who understand.
What IgAN treatments have you tried? Let others know in the comments below.
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Are there blood pressure medications that don’t increase serum potassium levels?
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