Battling Berger’s Disease

You have blood in your urine. You have had it for a couple of weeks now. You also have swollen ankles. You could have Berger’s disease.

Berger’s disease is also known as IgA nephropathy. IgA—immunoglobulin A—is an antibody, one of the body’s bullets for invading germs. In Berger’s disease, IgA antibodies land on the kidneys, inflaming them and causing them to bleed.

Bloody urine is the most striking feature of Berger’s disease. A sore throat, an intestinal infection, strenuous exercise and even muscle injection can bring on a bleeding episode. Sometimes the bleeding is so brisk, the urine turns red. At other times, only a microscopic examination of urine discloses red blood cells.

Berger’s disease can smolder for decades without causing trouble. However, within 20 years, half of Berger’s disease patients face kidney failure.

Berger’s disease is explained as the deposition of antibodies on the kidneys’ filtering stations, the glomeruli. Why is unclear. The best explanation for deposition of the destructive antibodies in the kidneys is the stimulation of the immune system, part of an autoimmune response.

Prognosis is difficult. Some patients display blood symptoms for decades without deleterious effect on kidney function. But others experience a rapid deterioration in function.

There is a genetic influence in some instances of this illness, but not all. It doesn’t mean your child is destined to have this disease.

Some symptoms of Berger’s disease include:

§  Visible blood in the urine (hematuria).

§  Flank pain (in the sides of your back).

§  Ankle swelling (edema).

§  High blood pressure (hypertension).

§  Proteinuria (having too much protein in the urine), which can cause edema (swelling) and foamy urine.

Some complications of this disease are high blood pressure; acute kidney failure (suddenly losing kidney function); chronic kidney failure (slowly losing kidney function over time); nephrotic syndrome (several symptoms together that indicate kidney damage, including high protein in the urine, swelling and high cholesterol); heart or cardiovascular problems; and IgA vasculitis.

Your health care provider will run a number of tests in order to diagnose you. Some tests such as a physical exam, a urinalysis, blood tests, estimated glomerular filtration rate blood tests, urine protein test and a twenty-four hour urine studies test are best for a detailed diagnosis.

In addition, your physician may perform a kidney biopsy, where your doctor uses a needle to remove a small piece of kidney tissue. A pathologist will then look for IgA deposits in the glomeruli and examine the tissue for the extent of the damage.

Often, doctors prescribe ACE inhibitors for people with this illness. ACE inhibitors are blood pressure medicines. They are used here not to lower blood pressure but to protect the kidneys. Blood pressure may rise as a consequence of this disease, then the ACE inhibitors serve a dual purpose.

Further, if kidneys show signs of deterioration, then you might need cortisone drugs to temper the antibody production.

Some people can live with the disease for many years. But the illness may progress in other patients where they may need kidney dialysis or transplant.

There is really no way to prevent Berger’s disease. The best course of action is to monitor your blood pressure and cholesterol.