Your kidneys play a key role in how your body functions. These bean-shaped, fist-size organs help control blood pressure, manage fluid and salt levels, and filter waste from your blood.

Immunoglobulin A nephropathy (IgAN) — also called Berger’s disease — can interfere with these important jobs, but treatment can help slow kidney damage and protect kidney function. Medications and lifestyle changes are often part of managing IgAN. Below, we discuss six options that may help you maintain your kidney health.

What Is IgA Nephropathy?

IgAN is a form of chronic kidney disease. IgAN affects the kidneys’ delicate filtering units, called glomeruli. Normally, proteins called IgA antibodies help the immune system fight bacteria and viruses in places like the digestive tract, nose, and lungs. In IgAN, these IgA antibodies are abnormal, and the immune system reacts to them as if they were harmful.

ACE inhibitors and ARBs work by relaxing and opening your blood vessels, reducing stress on the kidneys.

Other antibodies attach to the abnormal IgA antibodies and form clumps called immune complexes. These clumps travel through the bloodstream but are too large to pass through the glomeruli. Instead, they build up as IgA deposits, causing inflammation and kidney damage.

IgA deposits eventually affect the kidneys, making it harder for your body to get rid of extra fluid and waste. Damaged kidneys may also leak blood and proteins into the urine.

Without treatment, IgAN can progress to kidney failure, or end-stage renal disease (ESRD). Between 20 percent and 50 percent of people with IgAN eventually develop kidney failure. Treatment options for kidney failure are limited to dialysis or a kidney transplant.

Sticking to your treatment plan can help slow kidney damage. Below are six approaches your doctor may discuss with you.

1. Blood Pressure and Diabetes Medications

Many people with IgAN have high blood pressure because their kidneys can’t filter out extra fluid from the bloodstream. This increases the amount of blood in your body, raising the pressure inside your blood vessels. High blood pressure also puts extra strain on the delicate blood vessels in your 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, such as lisinopril and benazepril, and angiotensin receptor blockers (ARBs), such as losartan and valsartan, 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 II 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 may help slow kidney damage in some people with IgAN.

Certain diabetes medications, called sodium-glucose cotransport 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.

2. Steroids

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.

3. Immunosuppressants

Researchers are developing targeted therapies that suppress specific parts of the immune system to help slow IgAN progression. Below are some currently approved immunosuppressant treatments.

Iptacopan

In 2024, the FDA granted accelerated approval to iptacopan (Fabhalta) to help lower protein in the urine in adults with primary IgAN who are at risk of the disease getting worse. Accelerated approval is based on early results and may be updated after more studies. 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.

A clinical trial is a research study that tests how well new medical treatments work in people. In clinical trials, participants took either iptacopan or a placebo (an inactive treatment used for comparison). Results showed that iptacopan lowered proteinuria significantly more than the placebo.

Atrasentan

Atrasentan (Vanrafia) is an endothelin receptor antagonist that targets endothelin A. This medication received accelerated approval for adults with primary IgAN who are at risk of disease progression. Atrasentan is the first medication of its kind approved to treat IgAN.

Sibeprenlimab-Szsi

Sibeprenlimab-szsi (Voyxact) blocks a proliferation-inducing ligand (APRIL). This APRIL inhibitor — also called an anti-APRIL monoclonal antibody — received accelerated approval to reduce proteinuria in adults who have primary IgAN and are at risk of progression.

4. Diuretics

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.

Steroids and other drugs that suppress the immune system may also be used to treat IgA nephropathy. One example, iptacopan (Fabhalta), was approved in 2024.

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.

5. Cholesterol-Lowering Drugs

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.

6. Dietary Changes

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. Processed foods, such as canned products and frozen meals, often have high amounts of sodium. Choosing nutrient-rich whole foods rather than heavily processed 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.

Work With Your Healthcare Team

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.

Join the Conversation

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

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