6 Types of Treatments for IgA Nephropathy

IgA nephropathy (IgAN) is a kidney condition where antibodies (immune system proteins) build up and cause damage in your kidneys. IgAN, also known as Berger’s disease, does not have a cure. However, treatments may help manage symptoms, control blood pressure, and slow down the process of kidney disease.

1. ACE Inhibitors or ARBS

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are first-line (first choice) treatments for IgA nephropathy. These blood pressure medications protect the kidneys and reduce proteinuria (protein in the urine, which is a sign of kidney damage).

Examples of ACE inhibitors (generic names end in -pril) include ramipril and Zestril (lisinopril). Examples of ARBs (generic names end in -sartan) include Cozaar (losartan) and Diovan (valsartan).

2. SGLT2 Inhibitors

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of drugs first developed for type 2 diabetes. They are also used for their protective effects on the heart and kidneys. For people with IgA nephropathy, SGLT2 inhibitors reduce proteinuria and protect the kidneys from further damage.

Examples of SGLT2 inhibitors (names end in -flozin) include Jardiance (empagliflozin) and Farxiga (dapagliflozin).

3. Corticosteroids

Corticosteroids, or steroids, work on the immune system by reducing the production of IgA, so your kidneys can relax and recover. Steroids are usually only given for six to nine months, since they are associated with side effects like high blood sugar, weight gain, and osteoporosis.

Examples of steroids include prednisone and Medrol (methylprednisolone).

4. Targeted-Release Steroids

While treatments like ACE inhibitors, ARBs, and SGLT2 inhibitors were initially developed for other conditions, newer options for IgA nephropathy were created and studied specifically for this disease.

Since steroids have many possible side effects, especially with long-term use, researchers have developed a targeted-release steroid called Tarpeyo (targeted-release budesonide).

Unlike traditional steroids, which work throughout the body, Tarpeyo delivers the medicine directly to the ileum (part of the lower intestine that is involved with IgA production).

Tarpeyo is specifically Food and Drug Administration (FDA)-approved to reduce the loss of kidney function in adults with IgA nephropathy who are at risk for disease progression. This medicine may help:

5. Endothelin Receptor [Type A] Antagonists (ERAs)

Endothelin receptor [type A] antagonists (ERAs) are a newer class of drugs that help reduce proteinuria and slow down the process of kidney damage.

Examples of ERAs include Filspari (sparsentan) and Vanrafia (atrasentan). Filspari is both an ERA and an ARB, so people who take this medicine do not take an additional ARB.

6. Complement Factor B Inhibitors

The complement factor B inhibitor Fabhalta (iptacopan) is used to reduce proteinuria in adults with IgA nephropathy. It works on a specific part of the immune system, known as the complement pathway, to reduce inflammation in the kidneys. However, researchers have not yet established whether this drug slows kidney decline in people with IgA nephropathy.

Making Lifestyle Changes for IgA Nephropathy

Lifestyle modifications may help manage IgA nephropathy, but they are not a substitute for other treatments recommended by your healthcare provider.

Here are some general lifestyle recommendations. Check with your healthcare provider to see which ones are appropriate for you:

• Limiting salt (sodium) intake: People with kidney disease are often advised not to consume more than 1,500 milligrams (mg) of sodium per day. Consult with your healthcare provider to determine the appropriate amount of salt to limit in your diet.
• Following the Mediterranean or DASH diet: These diets include eating high-fiber foods like fruits, vegetables, beans, and whole grains.
• Avoid smoking, vaping, and tobacco: Smoking or using tobacco products can worsen kidney disease and increase your risk of other conditions, such as high blood pressure and cancer.
• Maintaining a healthy weight: If you are overweight, weight loss may help improve your overall health.
• Exercising regularly: Exercise is recommended as a positive lifestyle change, but check with your healthcare provider before beginning any new exercise program.