You can take steps to reduce protein in your urine and maintain kidney function longer when living with IgA nephropathy.
IgA nephropathy (IgAN) develops when your body makes too much of an antibody called immunoglobulin A (IgA). Your immune system usually produces IgA to fight off a virus or bacteria. But when you have IgAN, your body makes extra IgA, which forms deposits in your kidneys, causing inflammation and damage.
Healthy kidneys contain about 1 million glomeruli, which filter your blood. They keep the nutrients you need, such as protein, in your body, and remove waste products that you don’t need. The waste leaves your system through your urine.
When the glomeruli are damaged in IgAN, they can’t filter your blood as effectively as they should. As a result, some protein leaks into your urine — a condition called proteinuria. High levels of protein in your urine can be a sign of greater kidney damage. Treatments for IgAN can help reduce proteinuria and preserve kidney function.
Here’s what you can do to protect your kidneys.
Medications play a crucial role in managing proteinuria in IgAN. You might need to take multiple types of medication, and it may take some time to figure out the right balance.
Healthcare professionals might recommend regular urine tests and blood work to monitor the effectiveness of the medications.
Make sure you understand how to take your medication, and let your doctor know if you have any questions about how to take it or any concerns about side effects.
ACE inhibitors and ARBs
Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are medications that can help manage your blood pressure and kidney health. Your kidneys play an important role in regulating your blood pressure. Even if you don’t have high blood pressure, these medications can be helpful for IgAN.
ACE inhibitors and ARBs are first-line treatments for IgAN. They work by lowering the pressure in your kidneys. As a result, the filtration rate slows down slightly so that your kidneys can keep up, capture more protein, and prevent it from leaking into your urine.
Corticosteroids
Corticosteroids are powerful anti-inflammatory medications used to treat many health conditions, including IgAN. Although they can decrease proteinuria and slow down IgAN progression, they can also have some serious side effects. For this reason, they should be used for only
Targeted corticosteroids are a newer option for IgAN. The Food and Drug Administration (FDA) has approved Tarpeyo, a targeted formula of budesonide, to treat IgAN. Like other corticosteroids, this medication can help decrease inflammation in your kidneys and preserve your kidney function.
The benefit of targeted corticosteroids is that they have fewer side effects than typical corticosteroids.
Endothelin receptor antagonists (ERAs)
ERAs target a hormone called endothelin, which narrows your blood vessels, increasing the pressure in your kidneys. These medications block the action of endothelin to reduce the pressure in your kidneys. As a result, they reduce inflammation and decrease proteinuria.
In the United States, two ERAs have been approved for IgAN: sparsentan (Filspari) and atrasentan (Vanrafia).
Sodium-glucose cotransporter 2 (SGLT2) inhibitors
SGLT2 inhibitors are a medication for type 2 diabetes. But a doctor might recommend that you take this type of medication to reduce proteinuria even if you don’t have diabetes.
SGLT2 inhibitors available in the United States include canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance).
A small 2023 study found that, when added to an ACE inhibitor or an ARB, SGLT2 inhibitors can reduce proteinuria in people with IgAN. SGLT2 inhibitors relax the filters in your kidneys to help them hold on to more protein.
Hydroxychloroquine
Hydroxychloroquine is a medication that has been used to treat malaria for years. It can also help treat autoimmune diseases such as rheumatoid arthritis. It settles down immune system activity to reduce inflammation.
A 2021 research review found that hydroxychloroquine may help reduce proteinuria.
Healthcare professionals may recommend this medication if other treatments have not effectively lowered the protein level in your urine.
You need some salt in your diet, but too much can raise your blood pressure and affect kidney health. A high salt diet can increase pressure on your kidneys, making it harder for them to filter out protein and leading to more protein in your urine.
One way to eat less salt is to limit your consumption of highly processed packaged foods and takeout.
If you use a lot of salt in your cooking, you might want to try experimenting with herbs and salt-free seasonings instead.
When your kidneys aren’t working at their best, you might need to eat less protein. Sources of protein include meat, poultry, fish, eggs, beans, nuts, seeds, dairy products, and soy products.
It’s still important to eat enough protein to meet your body’s needs. Unless a healthcare professional tells you otherwise, aim to consume 0.6 to 0.8 grams of protein per kilogram of your body weight daily. For example, if you weigh 100 kilograms, you can try to eat 60 to 80 grams of protein daily.
Additionally, avoid high protein eating patterns, which provide more protein than your body needs and can increase stress on your kidneys.
A diet rich in antioxidants may help reduce inflammation in your kidneys. Try to eat more antioxidant-containing foods, such as whole grains, nuts, seeds, beans, lentils, a variety of brightly colored fruits and vegetables, and healthy fats such as olive oil and fatty fish.
This eating pattern can also be helpful for managing or preventing high blood pressure, heart disease, and type 2 diabetes.
Smoking can be hard on your kidneys. In a 2021 study, researchers compared smokers and nonsmokers who had IgAN and found that cigarette smoking was associated with faster progression of IgAN.
If you smoke, consider quitting or cutting down. While quitting may not be easy, you can ask a healthcare professional for help finding a method that may work for you. Many resources are also available at SmokeFree.gov.
Your kidney health and blood pressure are
Many medications for high blood pressure can also treat proteinuria in IgAN. As part of your IgAN care, your healthcare team will regularly check your blood pressure.
Medications, exercise, and dietary changes can help you manage your blood pressure. If you smoke, quitting smoking can also be beneficial. Although quitting is not easy, a healthcare professional may be able to help you find a method that will work for you.
If you have diabetes, high blood sugar levels can damage the kidneys over time, which can increase proteinuria. Managing your blood sugar will help preserve your kidney function.
You can manage diabetes through a combination of medications, diet changes, and exercise.
If you don’t have diabetes, you’ll likely need regular blood work to check for any changes in your blood sugar levels. If you develop diabetes, identifying and treating it as early as possible can help protect your kidneys.
Proteinuria is a sign of kidney damage in IgA nephropathy (IgAN). You can take some steps to reduce the amount of protein in your urine and protect your kidney health.
Healthcare professionals might recommend that you take medications, try to quit smoking, and manage any other health conditions that can affect your kidneys.
It’s important to have regular urine tests and blood work to monitor your kidney health.