IgA Nephropathy (Berger’s Disease)

Written by Keri Wiginton
Medically Reviewed by Brunilda Nazario, MD on August 13, 2026

Also called Berger's disease, immunoglobulin A (IgA) nephropathy is an immune complex disease that affects your kidneys. 

IgA is an antibody, a protein your immune system makes to help fight germs such as bacteria and viruses. In autoimmune diseases, your immune system attacks parts of your own body. 

With IgA nephropathy, some of the IgA your body makes has less of a certain type of sugar. Researchers think this causes other antibodies to mistake the IgA as harmful and attach to it.

This immune complex can form clumps that build up in your kidney filters, called glomeruli. The buildup can cause inflammation and scarring that, over time, can make it harder for the glomeruli of your kidneys to work as they should.

While IgA nephropathy can be a serious lifelong condition, treatment options have grown in recent years, says Jeffrey Turner, MD, a nephrologist and director of the Nephrology Clinical Trials Program at Yale School of Medicine. 

"There are a lot of good treatments and a lot more that are going to be available in a short time, so it's becoming a more easily treatable disease," he says. "Having awareness, getting diagnosed, and getting monitored can lead to really good outcomes." 

How common is it?

Around 200,000 people are estimated to have IgA nephropathy in the U.S., where it's the most common primary disease of the kidney filters and makes up about 10% of kidney biopsies.

You can get IgA nephropathy at any age, but it often happens between the ages of 10 and 40. It's more common in men than women and people of Asian or White European ancestry.

Scientists don't know exactly what causes IgA nephropathy. Genetics likely play a big role, but there isn't one IgA nephropathy gene that gets passed down in a simple way.

"Rather than a single gene being responsible, it's plausible that a cluster of genes, and the various mutations that happen within those genes, will impact your risk for developing IgA nephropathy," Turner says.

That helps explain why the disease can run in families without being strongly inherited. In other words, having a relative with IgA nephropathy may raise your chances of getting it, but having the disease doesn't mean your children will get it. 

Genes probably aren't the only thing that matters. Researchers think infections and other environmental exposures may also help set the disease in motion. But they don't fully understand why these triggers lead to IgA nephropathy in some people and not others, or whether everyone with IgA nephropathy has genes that make them more likely to have the disease. 

Are there different types of IgA nephropathy?

Doctors may describe IgA nephropathy as primary or secondary, depending on whether another health condition seems to be involved. 

Primary IgA nephropathy 

Most people diagnosed with IgA nephropathy have the primary form. This means the disease develops on its own rather than because of another health condition. In these cases, doctors usually can't point to one specific reason why it happened. 

Secondary IgA nephropathy

Sometimes, IgA buildup in the kidneys happens with another disease. Conditions linked to secondary IgA nephropathy include: 

  • IgA vasculitis 
  • Liver disease, especially cirrhosis
  • Celiac disease, a digestive disorder where the body attacks the gluten protein
  • Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis
  • Some ongoing infections, such as HIV and hepatitis
  • Other autoimmune and inflammatory diseases

These conditions don't always cause IgA nephropathy. Researchers are still working out why they sometimes happen together and how they may be linked. 

Your doctor may look for a hidden condition when you're diagnosed. If they find one, treating it will be part of your overall treatment plan. 

You can have IgA nephropathy and not know it, often for years. If symptoms do show up, urine changes are usually the first clue. Some people notice blood-tinged pee during or shortly after an illness, such as a stomach bug, cold, sore throat, or other respiratory infection. 

Your pee may look: 

  • Pink, red, or tea-or-cola-colored (hematuria)
  • Foamy from higher levels of protein (proteinuria)

But blood and protein can also be present in amounts too small to notice. 

"Early detection relies on finding abnormalities in your urine that you wouldn't see — protein or blood only detectable under the microscope," says Brad H. Rovin, MD, director of the Division of Nephrology at Ohio State University Wexner Medical Center. 

When kidney problems become more severe, your body may hold on to extra fluid. This is called edema and may cause:

  • Puffiness in your face or around your eyes 
  • Swelling in your feet, ankles, legs, or other areas 

Contact your doctor if you suddenly get unexplained swelling, notice a change in the color of your pee, or your blood pressure rises unexpectedly. These symptoms may be a sign your kidney function is getting worse. 

Many people with IgA nephropathy feel fine and find out something is wrong only after routine blood or pee tests show signs of a kidney problem. 

If your doctor sees something off in your lab results, they may order:

  • Follow-up urine tests to check for blood and protein, including albumin
  • A creatinine blood test (to measure a waste product your kidneys normally filter out) 
  • An estimated glomerular filtration rate (eGFR) to show how well your kidneys are filtering blood

These tests and scores can show that something is affecting your kidneys, but they can't diagnose IgA nephropathy for sure. A kidney biopsy is the only way to do that. 

What happens during a kidney biopsy?

You'll get a kidney biopsy in a hospital or an outpatient center. Your doctor numbs an area of your back and may sedate you before using a needle to remove a small piece of tissue they'll send to a lab. Your doctor will use imaging, most often real-time ultrasound and sometimes a CT scan, to guide the needle to the correct spot.

After the biopsy, you'll spend several hours in recovery. They'll make sure you don't have bleeding or other complications. Your care team will let you know when you can get back to your usual activities. 

A pathologist looks at the tissue under a microscope. They'll check for IgA deposits in the kidney filters, along with signs of inflammation, damage, and scarring. These findings confirm the diagnosis and give your care team more information about what's happening with your kidneys.

Predicting your outlook

Your doctor may use the International IgAN Prediction Tool to estimate the chances of your disease getting worse over the next several years. It combines information such as your kidney function, urine protein, blood pressure, and kidney biopsy findings. 

The tool can't predict exactly what will happen to your kidneys. But it may help you and your doctor better understand your personal risk and talk through your treatment options.

Tests you'll need over time

IgA nephropathy can change without causing noticeable symptoms. You'll need regular checkups even if you feel well. 

Your doctor will keep an eye on: 

  • Protein in your pee 
  • Blood in your pee
  • Your eGFR and creatinine
  • Blood pressure

You may need frequent testing when you're first diagnosed, having a flare, or after starting certain medications. Once things settle, you may be able to space out your visits to once or twice a year.

Questions for Your Doctor 

Before your visit, write down your symptoms, when they started, and whether they've changed over time. Bring a list of all the medications and supplements you take, including the doses. 

During the visit, ask questions and take notes so you understand your condition and what comes next. You may also want to bring a trusted friend or loved one who can listen, take notes, and help you remember key details. 

You can ask: 

  • How well are my kidneys working now?
  • What are the chances my IgA nephropathy will get worse?
  • What do my kidney biopsy results mean?
  • How often will I need blood and urine tests? What do the results tell you? 
  • What are our goals for treatment?
  • What medications do you suggest, and what side effects should I know about?
  • Do I need to change how much salt, protein, or other nutrients I eat?
  • What symptoms or changes should I watch for?
  • When should I call you right away?
  • Should I see a nephrologist or any other specialists?
  • What other lifestyle changes can I make to protect my kidneys?
  • How might my other health conditions or medications affect my IgA nephropathy?
  • Are there clinical trials that might be right for me?
  • Where can I find reliable information about IgA nephropathy?
  • What's the best way to reach you if I have questions between visits?

Your doctor will have questions for you, too. They may ask: 

  • When did your symptoms start?
  • Do your symptoms happen all the time, or do they come and go?
  • Have you noticed blood, foaminess, or other changes in your pee?
  • Have you had swelling in your feet, ankles, legs, or elsewhere?
  • Does anything seem to make your symptoms better or worse?
  • Have you had any recent infections?
  • Does anyone in your family have kidney disease?

Your regular doctor may be the first person to notice a kidney problem through routine blood or urine tests. But you may need to work with a team of specialists for complete care. 

Your medical team may include: 

  • Nephrologist — a kidney specialist who usually manages your IgA nephropathy treatment
  • Primary care doctor — a regular doctor who can manage blood pressure and overall health
  • Nutritionist or dietitian — food and nutrition professionals who can help you follow a low-salt diet or make other diet changes 

Depending on your needs, your main kidney doctor may want you to see other specialists. For example, you may need treatment with a hepatologist if you have liver disease or a gastroenterologist if you have celiac disease or IBD. Your doctor will let you know what kinds of specialists are right for you. 

Treatment usually includes medications and healthy habits that protect your kidneys and lower protein in your urine. Depending on your chances of the disease getting worse, your doctor may also suggest treatment that targets IgA nephropathy more directly. 

Supportive treatment to protect your kidneys

If you have mild disease, you may only need regular lab tests to measure how well your kidneys are working. But your doctor may also suggest: 

ACE inhibitors or angiotensin receptor blockers (ARBs). These can lower pressure inside your kidney filters and lessen protein loss. They're blood pressure drugs, but your doctor will likely suggest one even if you don't have high blood pressure. 

SGLT2 inhibitors. Medications such as dapagliflozin (Farxiga) or empagliflozin (Jardiance) were first used for diabetes and heart disease. They're now used to slow declining kidney function and lower urine protein. Current guidelines recommend them as part of standard care for IgA nephropathy.

Lifestyle changes. Limiting sodium, staying active, maintaining a healthy weight, and not smoking or vaping can also help protect your kidneys and control blood pressure. 

Medications to prevent heart disease. Kidney disease can make heart and blood vessel problems more likely. Your doctor may suggest a cholesterol-lowering drug such as a statin or other treatment if needed. 

Diuretics. These medications help get extra fluid out of your blood when your kidneys can't. Your doctor may prescribe them along with blood pressure drugs. 

Targeted medications for IgA nephropathy

If protein in your pee stays high, your kidney function declines, or you're at higher risk of progression from the start, your doctor may suggest one of several FDA-approved treatments for IgA nephropathy. 

These include: 

Atacicept-vymj (Trutakna). This medicine blocks both B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL), two immune proteins involved in abnormal IgA production. This weekly shot received accelerated approval In 2026 to lower protein in the urine.

Atrasentan (Vanrafia). This medicine blocks endothelin A receptors involved in kidney damage. It received accelerated FDA approval in 2025 to lower protein in the urine. 

Delayed-release budesonide (Tarpeyo). This is a targeted corticosteroid made to act in the small intestine, where much of the abnormal IgA involved in the disease is thought to start. It's approved to slow the loss of kidney function. 

Iptacopan (Fabhalta). This is a complement inhibitor. It blocks part of your immune system (the complement pathway) that fuels inflammation and damage in IgA nephropathy. It's approved to slow the loss of kidney function.

Sibeprenlimab-szsi (Voyxact). It blocks APRIL, one of the immune proteins involved in making abnormal IgA. It's a shot you get every four weeks. It also received accelerated approval in 2025 to lower protein in the urine.

Sparsentan (Filspari). The drug blocks two receptors involved in pressure and damage inside the kidneys. Lowering that pressure can reduce protein leakage into your urine. It's approved to slow the loss of kidney function and replaces an ACE inhibitor or ARB rather than being taken with one.

Tonsillectomy for IgA nephropathy

A tonsillectomy is surgery to remove the tonsils. In Japan, doctors sometimes use it as part of treatment for IgA nephropathy. The idea is that removing the tonsils may reduce immune activity involved in the production of abnormal IgA. 

"The data from clinical studies showing that this is beneficial is very limited," says Jonathan Barratt, MD, Mayer professor of renal medicine at the University of Leicester in the United Kingdom. "There are no data to support the use of tonsillectomy as a treatment for IgA nephropathy outside of Japan." 

Recent guidelines say tonsillectomy shouldn't be used to treat IgA nephropathy in people who aren't Japanese. 

Early diagnosis, monitoring, and treatment can help protect your kidneys. But IgA nephropathy can cause lasting kidney damage and other health problems over time. 

Possible complications include: 

High blood pressure. Kidney damage can raise your blood pressure, and high blood pressure can cause even more kidney damage. 

Nephrotic syndrome. Rarely, IgA nephropathy can cause very high levels of protein in your urine. This can lead to swelling, low levels of protein in your blood, and high levels of cholesterol or triglycerides (fats in your blood).

Chronic kidney disease or kidney failure. Inflammation and scarring can slowly make it harder for your kidneys to filter waste and keep the right balance of fluids and minerals in your body. If kidney function declines far enough, you may need dialysis (a machine to filter your blood) or a kidney transplant.

Heart and blood vessel disease. Chronic kidney disease raises your odds of problems such as heart disease and stroke. 

Rapidly progressive IgA nephropathy (RPIgAN). Rarely, your kidney function may get worse quickly. Doctors define this as a drop in eGFR of at least 50% within three months after ruling out other possible causes. Your doctor will need to figure out what's going on and treat this right away. 

One of the most important ways to protect your kidneys is to follow a long-term treatment plan. That includes making healthy choices every day.

"I think one of the blind spots we have in medicine is we focus too much on medications and not enough on lifestyle," Turner says. 

Some things that can help protect your kidneys: 

Go easy on salt. Too much sodium can raise your blood pressure and make your body hold on to extra fluid. Aim for less than 2,300 milligrams of sodium a day, or the amount your doctor suggests. 

Eat for heart health. Turner often suggests a Mediterranean-style eating pattern built around fruits, vegetables, whole grains, and other minimally processed foods. If your kidney function declines, you may need to shift certain nutrients, such as potassium. A dietitian can help you make changes safely. 

Stay active. Regular exercise can help control your blood pressure and support your heart and kidney health. Start slowly if you haven't worked out in a while. 

Don't smoke. The chemicals in cigarettes can hurt your kidneys and raise your chances of heart disease and stroke. 

Drink the right amount of fluid. It's important to stay hydrated. But you don't need to flood your kidneys. Turner suggests aiming for about 2 liters of fluid a day. You may need more or less, depending on things like how active you are. Ask your doctor how much fluid is right for you. 

Living with IgA nephropathy can bring stress, uncertainty, and changes to your daily life. Taking care of your emotional health is a key part of managing your disease. 

Here are some things that may boost your well-being: 

Speak up about what you need. Ask questions, share your concerns, and tell your care team when something doesn't feel right. You should feel heard and comfortable asking for an explanation. 

Get support. Talk with friends, family, or other people who understand what it's like to live with kidney disease. A support group can also help you feel less alone. 

Talk to a mental health professional. A therapist, counselor, psychologist, or psychiatrist can help if worry, sadness, or stress becomes hard to manage on your own. Your doctor or social worker can help guide you to the right person.

Keep doing things you enjoy. Make time for hobbies, relationships, and activities that are fun or give your life meaning. 

Find ways to manage stress. Exercise, meditation, breathing exercises, yoga, or spending time doing something that brings you joy may help you relax and recharge. 

Stay on top of your care. Keep your appointments, take your medications as prescribed, and let your doctor know about changes in your physical or emotional health. 

IgA nephropathy is a lifelong condition, but there's no single path for everyone. Some people have mild disease and keep good kidney function for decades. Others lose kidney function more quickly. 

About 1 in 5 people with IgA nephropathy may get kidney failure within a decade of diagnosis. Around 25%-50% could get kidney failure within 20-30 years. But regular monitoring and treatment can help protect your kidney function and lower your chances of the disease getting worse.

How your condition might change over time 

IgA nephropathy may: 

  • Go into remission (more common in kids) 
  • Stay mild or stable for many years
  • Slowly cause kidney function to decline
  • Lead to kidney failure 

"Even when you treat IgA nephropathy effectively, there's always a chance it can come back months or years later," Turner says. 

Your doctor will look at several things to estimate how likely your IgA nephropathy is to get worse. Two of the most important are how much protein is in your urine and how well your kidneys are working. Your blood pressure, age, and kidney biopsy also help your doctor gauge your outlook. 

How your results change over time also matters. In particular, keeping urine protein low is linked to better long-term kidney health. 

IgA nephropathy and life expectancy

Some studies show that people with IgA nephropathy may have a slightly shorter life expectancy than people without the disease. But these averages can't predict how long any one person will live. 

IgA nephropathy may be hard to see from the outside. Your loved one may feel well even when tests show that their disease needs treatment or close monitoring. 

You can help by learning more about your loved one's lab tests and why they matter. Urine or pee protein, kidney function, and blood pressure can tell the care team a lot about how the disease is doing. 

You can also help your loved one: 

  • Keep track of visits, test results, and medications
  • Think of questions before doctor visits
  • Watch for new swelling or blood pressure spikes
  • Make lower-sodium meals
  • Find ways to be active together
  • Manage any medication side effects 

If your loved one has advanced kidney disease, ask their care team what kind of help they may need in the future and what you can expect to change over time. 

There are online and in-person resources that can help you connect and feel less alone as you navigate life with IgA nephropathy. Some of the groups you can turn to for information and support include: 

Your doctor or a social worker on your care team may also know of local or national support groups. 

Immunoglobulin A (IgA) nephropathy, also called Berger's disease, is a rare immune complex disease that affects your kidneys. Early signs of IgA nephropathy include blood and proteins detected in your pee, but it can only be diagnosed with a kidney biopsy. 

If you notice your pee is tea-colored, cola-like, or reddish, see your health care provider right away. Early treatment can help you live a long life and reduce the need for dialysis or a kidney transplant.

What are the stages of IgA nephropathy?

Your doctor may use your eGFR and urine protein levels to describe how much kidney damage you have and your risk of the disease getting worse. 

  • Stage I: eGFR of 90 or higher, with signs of kidney damage
  • Stage II: eGFR of 60-89, with signs of kidney damage
  • Stage IIIa: eGFR of 45-59; mild to moderate loss of kidney function
  • Stage IIIb: eGFR of 30-44; moderate to severe loss of kidney function
  • Stage IV: eGFR of 15-29; severe loss of kidney function
  • Stage V: eGFR below 15; kidney failure

Which foods should you avoid with IgA nephropathy?

You may need to limit salt and avoid eating more protein than your body needs. Too much sodium can raise blood pressure and worsen swelling, while extra protein may put added stress on your kidneys. Ask your doctor or a kidney disease dietitian what's right for you before you make major diet changes.

Can I live a long life with IgA nephropathy?

With effective treatment, you can live a long life and keep doing things you enjoy. 

Can IgA nephropathy be reversed?

IgA nephropathy can't be reversed or cured, but treatment can slow or prevent further kidney damage. Some people may reach remission and maintain good kidney function for many years.

Add WebMD as a Preferred Source to see more of our trusted content across Google Search, AI Overviews, and AI Mode