There is no cure or reversal for IgA nephropathy (Berger’s disease). However, many people achieve remission, which is when disease progression and kidney damage slow.
Once kidney scarring (fibrosis) develops, it is permanent. The scarring replaces healthy kidney tissue with stiff tissue that no longer filters your blood the way it should.
Remission means the disease has become less active.
During remission, the amount of blood and protein leaking into your urine because of IgA nephropathy drops. Kidney function typically stabilizes, helping protect the healthy kidney tissue you still have. This lowers your risk of long-term complications.
For children, remission may happen spontaneously. For most people, remission occurs with treatment.
About 20% of people with IgAN progress to end-stage kidney disease within 10 years. However, with treatment and close monitoring, it is often possible to slow or stop further injury and preserve kidney function for many years.
1. Take Blood Pressure Medications
Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are blood pressure medications that reduce stress on your kidneys. Lowering pressure inside your kidney’s filters, the glomeruli, reduces urine protein and helps limit kidney injury.
Examples of medications include:
- Prinivil (lisinopril)
- Vasotec (enalapril)
- Cozaar (losartan)
- Diovan (valsartan)
2. Use Immune-Targeted Treatments
If you’re at higher risk for kidney damage, your doctor may prescribe immune-calming medications.
Tarpeyo (budesonide) calms the immune system where abnormal IgA is made. Depending on the case, your provider may order a low-dose steroid like Medrol (methylprednisolone) instead.
Fabhalta (iptacopan) targets a different immune pathway that causes kidney inflammation. It’s an option if you need immune treatment without steroids.
3. Try Newer IgAN-Specific Therapies
In the past, IgAN care mainly focused on controlling blood pressure and slowing kidney damage. Now, newer medications target the disease more directly. These include:
- Endothelin receptor antagonists (ERAs): ERAs like Vanrafia (atrasentan) and Filspari (sparsentan) help relax blood vessels in your kidneys, reducing protein in your urine (proteinuria) and slowing kidney damage. Filspari (sparsentan) is unique because it works as both an ERA and an angiotensin receptor blocker (ARB). Because it already includes ARB action, you should not take it with ACE inhibitors.
- SGLT2 inhibitors: Researchers originally developed SGLT2 inhibitors like Jardiance (empagliflozin) and Farxiga (dapagliflozin) to treat diabetes. But these medications can also protect your kidneys by reducing proteinuria, even in people without diabetes. You can take these alongside ACE inhibitors or ARBs.
4. Consider Emerging Therapies and Clinical Trials
Voyxact (sibeprenlimab) is a newer injection given every four weeks. It works early in the disease process by targeting the APRIL protein, which helps reduce abnormal IgA buildup. The U.S. Food and Drug Administration (FDA) granted accelerated approval based on the medication’s ability to lower urine protein. Ongoing trials are studying whether it protects kidney function long-term.
If you want to explore current studies, you can search clinicaltrials.gov to view active trials by location and eligibility.
To see if your kidneys are healing, healthcare providers may do the following three things:
1. Test Your Urine for Protein and Blood
Providers check for protein in your urine with spot urine tests like uPCR or uACR. They may also order a 24-hour urine sample. Treatment plans aim to keep protein levels below 0.3-0.5 grams per day.
Dehydration, infections, and intense exercise can also increase urine protein levels. Because of this, providers watch for trends over time rather than just one result.
Providers also order periodic urine testing to check for microscopic blood not visible to the naked eye.
2. Test Your Kidney Function
The estimated glomerular filtration rate (eGFR) is a blood test that measures how fast your kidneys filter waste. Rather than looking for one single number, providers watch eGFR values over time. The treatment goal is minimal yearly decline.
3. Measure Your Blood Pressure
High blood pressure can damage small blood vessels in your kidneys. Providers typically recommend keeping blood pressure below 130/80 but often set a target of below 120/70 for people with IgAN.
Early diagnosis, close monitoring, and newer treatments can slow progression and reduce the risk of complications. Here are a few things you can do to protect your kidneys:
- Limit sodium to 2,300 milligrams per day and choose fresh foods over processed ones.
- Treat infections early.
- Avoid non-steroidal anti-inflammatory drug (NSAID) medications like Advil or Motrin (ibuprofen) and Aleve (naproxen).
- Stay hydrated and active.
- Avoid smoking.
- Schedule regular visits to a nephrologist (kidney specialist) for monitoring.
- Ask your provider about newer treatment options or clinical trials.
Call your nephrologist if:
- You notice dark or cola-colored urine.
- You develop new or worsening swelling in your legs, ankles, or eyes.
- Your home blood pressure readings rise above your target range.
