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IgA nephropathy (Berger’s Disease)
What is IgA nephropathy
IgA nephropathy (IgAN) is one of the most common inflammatory kidney diseases in the world. It is most common in Asian populations, followed by Caucasians, and relatively infrequent among African populations. This striking difference in IgAN populations, along with the known familial connections, leads to the conclusion that IgAN has an inherited mechanism. Recently three studies on IgAN have identified 7 genetic areas, providing initial insight into the genetics of this trait. Although there is a genetic component to IgAN it is only related to the production of abnormal forms of IgA (a circulating protein in the blood i.e. immunoglobulin) and the amount produced. These immunoglobulins produced bind with other components of the immune system (antibodies).
Basically for those prone they just make a lot of this type of protein due to a B-cell (an immune system cell) issue in the mucosa. The problem is that the IgA and the antibodies gets caught in the kidney and causes inflammation and an increase in free radicals and growth factors which in turn causes kidney damage. IgA is produced in the bone marrow and mucus membranes of the body (e.g. the sinuses, lungs and gut). If these areas get inflamed or activated inappropriately the predisposed individuals make an abnormally large amount of IgA and antibodies that then gets stuck in the kidney causing damage.
The treatment then is to not just focus on the kidney but to focus also on the tissues which may be producing large amounts of abnormal IgA, for example the gut. It is possible that some subpopulations with this disease may actually have gut issues caused by foods they are sensitive to that is then causing a downstream affect on the kidney. This may be why if an IgA patients gets a transplant, the new kidney gets damaged as well, simply because it is not primarily a kidney issue, it is a mucosal issue (or immuine cells in the mucosa; like B-cells) that is activated by foods or infections (bacterial, virus, fungus, parasites) that is causing the production of the abnormal IgA i.e. the kidney issue is the consequence of something else, the kidney is not the root cause! It is the affected organ from which the production of abnormal IgA and its antibodies.
Here at the Vancouver Kidney Health Clinic® we may do blood tests, apply a restricted diet, look into clearing the possible affected mucus membrane thus decreasing the production of abnormal IgA. We will also use natural substances to try to decrease free radical stress, growth factors that can lead to congestion in the kidney, decrease proinflammatory mediators, decrease scarring (fibrotic) mediators, and decrease something know as compliment activators (these increase the inappropriate immune response in the kidney when the IgA/antibody get caught in the kidney). We do this in conjunction with a modified diet, acupuncture and possible medications known as ACE inhibitors and immune suppressants like prednisone if required (you may already have been given these by your M.D. or nephrologist). The treatment depends on your stage of disease and your overall constitution or state of health.