Guide To The Treatment Of Berger's Disease

Berger's disease (IgA nephropathy) is a kidney condition that develops when an antibody called IgA becomes stuck in the kidneys. This gradually produces localized inflammation that may accumulate over the course of two decades. Eventually, Berger's disease can cause kidney failure. Berger's disease patients may have no symptoms for many years, and the condition is often detected during routine blood tests for another health concern. When symptoms do appear, they generally include high blood pressure, dark (tea or cola) urine, visible blood in the urine, and swelling of the hands and feet. Patients may also have back pain along one or both sides of the back below the ribs. To diagnose this condition, patients will need urine and blood tests. A kidney biopsy and an iothalamate clearance test may be necessary in some cases.

The treatments described below are part of the standard protocol for managing patients with Berger's disease.

Statin Therapy


Statin therapy is used to reduce cholesterol. For patients with Berger's disease, a reduction in cholesterol can slow down the rate of kidney damage, enabling patients to have a better quality of life. Some of the most commonly prescribed statins for patients with this disease include atorvastatin, fluvastatin, lovastatin, pitavastatin, and simvastatin. While taking statins, patients should be aware of potential side effects such as muscle or leg pain, vomiting, stomach cramps, and brown-tinted urine. Patients should report any troublesome or concerning side effects to their healthcare team. Since there is a large variety of statins on the market, doctors may be able to switch patients to another drug with fewer side effects. While taking statins, patients will have regular follow-up appointments and blood tests to monitor their cholesterol and kidney function.

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Medications For High Blood Pressure


High blood pressure is one of the major complications for patients with Berger's disease, and medications for high blood pressure are often required. Typically, doctors will start by prescribing angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). These reduce blood pressure and have also been shown to slow the progression of kidney disease. For optimal blood pressure control, some patients may also need to take beta blockers or calcium channel blockers. While taking these medications, patients may wish to monitor their blood pressure regularly at home. Readings taken at home can help providers know when medication alterations are needed. While taking blood pressure medication, patients should watch for common side effects, which include coughing, constipation, diarrhea, dizziness, nervousness, and fatigue. If patients develop a frequent cough while taking a particular blood pressure medication, they may be able to switch to another type that does not produce this side effect. While using blood pressure medicines, patients will have routine follow-up appointments to have their blood pressure measured at their healthcare provider's office.

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Immunosuppressants are appropriate for some patients with Berger's disease, and they help maintain existing kidney function. They also decrease the amount of kidney inflammation a patient has. Some of the immunosuppressants typically used for patients with Berger's disease include corticosteroids and cyclophosphamide. Since these medications can cause very serious side effects, doctors will evaluate the risks and benefits of these for each patient prior to writing a prescription. Some examples of the types of side effects that may occur while taking immunosuppressants include high blood pressure and elevated blood glucose. With this in mind, doctors will prescribe the lowest effective dose for the shortest possible time. Patients will be closely monitored, and they should report any new or worsening symptoms immediately. Since immunosuppressants can make patients more susceptible to infections, they may need to avoid individuals who have influenza or other infectious ailments. Prior to beginning immunosuppressants, patients should ensure they are up to date on all vaccinations, including influenza and pneumonia vaccines.

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Fish Oil Supplements


Fish oil supplements are an ideal source of omega-3 fatty acids. Omega-3s have been shown to naturally reduce inflammation without causing negative side effects. Patients interested in fish oil supplements should research the potency of the brands they are considering. It is important for Berger's disease patients to consult a physician or pharmacist about a safe dosage. Fish oil capsules also tend to be quite large, and some patients may have difficulty swallowing them, thus, if necessary, patients can open the capsules and pour the liquid into a drink or on top of a meal. For patients who are allergic to fish, plant-based omega-3 supplements are available, and chia seeds, walnuts, and flaxseeds are excellent dietary sources of these fats as well. Patients who supplement their diets with fish oil sometimes choose to take it with another supplement called mycophenolate mofetil. Like fish oil, this supplement has no side effects, and it can reduce protein in the urine for patients who have not responded to other treatments.

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Eat Less Protein


Inside the body, dietary protein is broken down into waste products the kidneys must filter. Since consuming more protein increases the workload placed on the kidneys, doctors often recommend that Berger's disease patients eat less protein. Doctors believe this could slow the progression of kidney decline. Patients may need to cut back or eliminate high-protein foods like meat, eggs, and nut butter from their diet. To sufficiently reduce protein, some patients have found it helpful to eat a primarily plant-based diet. Whatever diet a patient chooses to follow, they will likely be asked to count their daily protein intake and keep it below a certain threshold. Since eating a low-protein diet can be challenging, patients may wish to have consultations with a nutritionist to get advice on appropriate meal planning. Patients will have their protein levels tracked by routine blood and urine tests during medical appointments.