In the United States, the average life expectancy is about 78 years. If you have a chronic kidney disease (CKD) like immunoglobulin A nephropathy (IgA nephropathy or IgAN, also called Berger disease), you may worry that your life expectancy could be lower. IgAN can shorten your life for many reasons, including increasing your risk of cardiovascular disease (diseases of the heart and blood vessels).

This article will review the most important factors that influence life expectancy in IgA nephropathy and what you can do to improve it.

What Factors Influence Life Expectancy With IgAN?

When you have IgAN, your life expectancy can be influenced by your age, sex, and kidney function, as well as other medical conditions. It will also be highly influenced by how fast IgAN progresses in your body. Some people find that it moves slowly, while others find that it gets worse more quickly.

Kidney Function

Kidney function can be evaluated by calculating an estimated glomerular filtration rate (eGFR), which tells how well your kidneys are filtering the blood. This is commonly calculated using a formula based on the levels of blood creatinine (a waste product), your age, and your sex. Your eGFR, measured as milliliters per minute per 1.73 square meters, helps your doctor determine your stage of chronic kidney disease.

The stages of chronic kidney disease are used to determine how much kidney damage IgAN has caused. Not everyone diagnosed with IgAN will progress all the way through the stages and reach kidney failure. Many people stay stable for years as long as the condition is managed well. Your nephrologist can give you the most information about your personal prognosis. The lower the levels of your eGFR, the lower the kidney function. The kidney function associated with each stage of kidney disease is as follows:

• Stage 1 — 90 or higher
• Stage 2 — 60 to 89
• Stage 3a — 45 to 59
• Stage 3b — 30 to 44
• Stage 4 — 15 to 29
• Stage 5 — Less than 15

Stage 5 chronic kidney disease is also known as end-stage renal disease (ESRD) or end-stage kidney disease.

Life expectancy is significantly affected when eGFR falls below 60 milliliters per minute per 1.73 square meters (stages 3a, 3b, 4, and 5). For example, according to findings published in the journal Pediatric Nephrology, life expectancy falls by about 20 percent in men ages 30 to 44 with stage 3a chronic kidney disease, by about 50 percent in stage 3b, and by about 65 percent in stage 4.

Talk to your doctor to find out what your eGFR is and how it might affect your life expectancy.

Age and Sex

According to one study from Eastern Europe published in the journal Medicina, males may be more likely to progress to end-stage kidney disease than females. The study showed that being male was one significant risk factor for having IgAN develop beyond the early stages. Overall, males may be more likely to have faster disease progression, which may lower life expectancy.

Another study suggested that most people with IgA nephropathy progress to kidney failure within 10 to 15 years of being diagnosed. This means that being diagnosed younger might significantly shorten your life expectancy, while being diagnosed when you’re older may still allow you to live your normal lifespan.

Other Medical Conditions

Other medical conditions that commonly occur with IgAN can also influence your life expectancy. Hypertension (high blood pressure) is common in people who have this kidney disease. High blood pressure in a middle-aged person can reduce life expectancy by two to three years, though figures vary. If you have high blood pressure when you’re diagnosed with IgAN, your life expectancy may be shorter, too.

How Does IgA Nephropathy Influence Life Expectancy?

Immunoglobulin A nephropathy (IgAN) is a condition in which an immune system protein called IgA becomes faulty and damages your glomeruli (filtering units in your kidney), causing kidney disease. This may occur after an infection, when your body is producing high levels of IgA, which is carried by the blood to the kidneys, where it gets stuck in the glomeruli and causes inflammation.

A 2018 study in the United States found that life expectancy in people with IgA nephropathy decreased by about 10 years. In a 2019 population-based study from Sweden, researchers found that people with IgA nephropathy died about six years earlier than those without the disease.

One way to evaluate life expectancy with IgAN is to look at your level of proteinuria (how much protein is in your urine). Your nephrology team will likely check this every time you see them. If you can keep it relatively low, your life expectancy may be significantly higher. People who successfully managed IgAN and kept these levels low were more than 90 percent likely to stay free of kidney failure for at least 10 years. If those levels go up even a little bit and you can’t get them back down, your survival rate goes down significantly, and IgAN disease progression speeds up.

How Does IgAN Treatment Affect Life Expectancy?

The type of treatment for your kidney disease can also influence your life expectancy. Many people with IgAN never reach end-stage kidney disease, and early treatment can help them live longer.

IgAN often damages the kidneys slowly. Doctors treat it by lowering protein in the urine and controlling blood pressure with medicines like ACE inhibitors, ARBs, or newer drugs such as sparsentan. Getting proteinuria (protein in the urine) under control and keeping blood pressure low can slow how fast your kidneys get worse, which means you are less likely to reach kidney failure quickly. Delaying or preventing kidney failure can help you live longer and stay healthier by lowering the risks of late-stage kidney disease.

For people with end-stage kidney disease, dialysis is associated with living longer compared with more conservative therapy. A person starting dialysis can expect to live about 5 to 10 years, though survival rates vary, according to the National Kidney Foundation. However, many people have lived much longer — 20 to 30 years — while on dialysis treatment.

A kidney transplant is the best available treatment option for ESRD. People who get a kidney transplant typically live 10 to 15 years longer than they would have if they’d stayed on dialysis, according to Beth Israel Deaconess Medical Center.

How Can You Improve Life Expectancy?

Keeping your kidneys healthy may help improve your life expectancy. IgAN can cause complications that not only worsen the condition itself but also increase your risk of heart disease, such as high blood pressure and high cholesterol.

Manage Complications of IgAN

You and your healthcare team will develop your personal treatment plan that will help you prevent IgAN from getting worse or causing complications. Possible complications you may experience with this kidney disease include:

• Acute kidney injury (when kidney function suddenly worsens)
• High blood pressure
• Cardiovascular issues
• High cholesterol (high levels of fat in the blood)
• Edema (swelling)
• Anemia (low levels of red blood cells)
• Bone disease
• Blood vessel problems
• Acidosis (buildup of acid in your blood)

There are several lifestyle changes you can make that will help you manage both IgAN and some of these complications. Your doctor may suggest:

• Losing weight in a healthy way
• Quitting smoking or other tobacco use, if you smoke
• Getting equipment to check your blood pressure at home
• Exercising more
• Staying away from supplements unless your doctor approves them
• Lowering your salt intake
• Eating less protein if you are not on dialysis
• Avoiding infections

If you need support to follow through with any of these, your nephrologist can refer you to other medical specialists who can help.

Prevent Heart Disease

Your risk for heart disease often goes up as your kidney function gets worse. Protecting your kidneys also means protecting your heart. There are also steps you can take directly that may help prevent heart disease, like:

• Follow your doctor’s advice to keep your blood pressure below 140/90 millimeters of mercury (mm Hg) or below the target blood pressure decided by your doctor, and to achieve healthy cholesterol levels.
• If you have diabetes, keep your blood sugar levels under control.
• Maintain a healthy weight.
• Stay active, logging about 30 minutes of physical activity on most days.
• Eat nutritious, balanced foods that fit with your kidney diet.
• Limit the amount of salt you eat — most people with kidney disease or hypertension should get less than 1,500 milligrams each day.

Talk to your nephrologist and other members of your healthcare team to learn more about what you can do to care for your kidneys and improve your life expectancy.

Join the Conversation

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

What are you doing to improve your outlook while living with IgAN? Let others know in the comments below.