Losing weight with chronic kidney diseases like IgA nephropathy (IgAN) may occur for a wide range of reasons. Weight changes in kidney disease can be confusing. In the early stages of the disease, you may actually gain weight because of fluid buildup. However, advanced-stage kidney disease can cause unintended weight and muscle loss as kidney function declines.

In addition, some people with IgAN may choose to lose weight on purpose in an attempt to reduce excess body fat. What’s important is whether you’re losing fat, muscle, or bone. Your healthcare provider can help you decide if weight loss is a good decision for you and figure out a safe goal. Here are some things to keep in mind about weight loss with IgAN.

Unintentional Weight Loss in Advanced IgAN

Advanced IgAN can lead to weight loss due to decreased muscle mass. This effect is known as muscle wasting or sarcopenia. It can mean the disease is severe and your health is at risk.

Chronic kidney disease and end-stage kidney disease (kidney failure) can promote muscle breakdown and impair muscle growth because of the following effects:

• Increased loss of proteins
• Higher acid levels in the body
• Hormonal shifts (including changes in insulin, growth hormone, and testosterone)
• Increased inflammation that affects cellular energy
• Reduced vitamin D levels
• Accumulation of toxic wastes

Some people lose weight with advanced IgA nephropathy because of symptoms like nausea and vomiting. Taste changes and a loss of appetite can make it hard to take in enough calories to maintain a healthy weight. If your kidney function is significantly impaired, you may also need to restrict certain foods including proteins. Your doctor will let you know what diet and restrictions you need to follow depending on your kidney disease stage, blood tests, and treatment plan.

If you’re losing weight without trying, talk to your doctor right away. They can help pinpoint the cause. You should also be mindful of changes in your physical strength, even if your weight hasn’t changed. It’s essential to get the nutrition you need to feel your best and maintain strong bones and muscles.

Dialysis and Kidney Transplants

About a quarter of adults with IgAN eventually develop kidney failure. The only ways to treat kidney failure are dialysis or a kidney transplant.

Dialysis is associated with sarcopenia. People on dialysis lose protein directly during their treatment sessions. In addition, they may have a loss of appetite and poor quality or inadequate dietary intake. People on dialysis also tend to be less physically active. All these factors promote muscle loss, which can reduce weight and strength.

If you are on dialysis, your healthcare provider can talk to you about exercises, diet plans, and other interventions specifically tailored to you to reduce negative effects on muscle mass.

Studies on people who have had kidney transplants show that it’s possible for people with kidney failure to recover from muscle wasting. Low dose corticosteroids and physical activity may help rebuild muscle under the supervision of a healthcare provider.

What About Weight Gain?

Your doctor may calculate your body mass index (BMI) using your height and weight to indicate how much fat is on your body. A healthy BMI score is considered to be between 18.5 and 24.9 kilograms per square meters. A BMI score of 25 to 29.9 is defined as being overweight, and a BMI score of 30 or higher is defined as obesity.

Obesity is associated with other health problems that can complicate life with IgAN, such as:

• Type 2 diabetes
• Hypertension (high blood pressure)
• Hyperlipidemia (high cholesterol)
• Coronary heart disease
• Sleep disorders

Since obesity can promote inflammation, high blood pressure, and high blood sugar, people with IgAN should be mindful about maintaining a healthy weight. These issues can speed up kidney damage if left untreated.

IgA nephropathy is an immune system disorder caused by abnormal IgA immune deposits. Extra body weight doesn’t cause IgAN. Likewise, losing weight won’t cure IgAN. However, your healthcare provider may recommend weight loss if they believe it would improve your overall health and ultimately the health of your kidneys.

Dietary Restrictions and Weight Management

The early stages of IgAN don’t require changes to your diet. But if you’re living with advanced kidney disease, you may have to follow a special diet to help balance the levels of electrolytes, minerals, and fluid in your body. Your healthcare provider will base these recommendations on your blood test results. These restrictions can lead to weight gain or weight loss, depending on the person.

Examples of foods you may need to limit if you have kidney disease include:

• High-sodium foods — Added table salt, packaged foods, and fast food
• Protein — Meat, beans, and nuts
• High-phosphorus foods — Deli meat, dairy products, oatmeal, beans, and soft drinks
• High-potassium foods — Oranges, bananas, potatoes, dairy products, and whole wheat bread

If you’re put on dialysis, these restrictions are slightly different. If you’re advised to change your diet, ask to meet with a registered dietitian. They can help you find nutritious, kidney-friendly foods that support a healthy weight. Adjusting your portion sizes, spacing out your meals, and drinking the right amount of water can also help reduce kidney stress and damage.

Maintaining a Healthy Weight

Always ask your healthcare provider about sudden weight changes. Weight loss or gain could mean that your kidney health has changed or there’s another underlying health issue.

Aside from what you eat, your weight is also influenced by other lifestyle factors, including physical activity, stress, and sleep. Physical activity is good for your mental and physical health. People with IgAN can benefit from strengthening exercises to support strong muscles.

But before you jump into a new workout routine, be sure to ask your healthcare provider. They’ll help you focus on adequate nutrition, muscle preservation, and symptom management rather than weight loss alone. They can also make sure it’s safe for you to exercise and give you advice on how to get started.

Join the Conversation

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

How do you maintain a healthy weight with IgAN? Let others know in the comments below.