Complications of IgA nephropathy: What to look out for
Reviewed by 
Immunoglobulin A nephropathy (IgAN), also called Berger disease, is a condition that affects how well your kidneys can filter waste products out of your bloodstream. As your kidneys lose the ability to filter your blood, the risk for IgA nephropathy complications increases.
As you navigate living with the disease, it’s important to understand what the common and uncommon complications of IgA nephropathy are, how they’re identified, and when you shouldn’t wait to get medical care.
Does everyone with IgA nephropathy develop complications?
IgAN complications don’t affect everyone; many people with the condition live full, active lives without developing severe symptoms.
Your risk depends on how much protein is leaking into your urine (proteinuria), your blood pressure, your kidney function, how much kidney scarring is present, and how well your risk factors are controlled.
Regular monitoring helps your healthcare team spot changes early and adjust treatment to prevent or delay the onset of serious issues.
Potential complications
This table provides an overview of the issues for which your care team will monitor:
Scroll horizontally to view all columns -->
| Potential complication | How it’s detected | Possible symptoms | Typical monitoring |
| High blood pressure | Blood pressure readings at home and in the clinic | Often none; headaches in some people | Regular blood pressure checks and medication adjustments |
| Ongoing protein in urine | Urine protein-to-creatinine ratio | Foamy urine, swelling, or no symptoms | Repeat urine tests, medications, lifestyle changes |
| Chronic kidney disease | Blood tests, urine tests | Fatigue, swelling, changes in urination | Routine kidney function monitoring |
| Kidney failure | Declining kidney function tests | Severe fatigue, nausea, fluid overload | Referral for dialysis or transplant planning if needed |
| Acute kidney injury | Sudden drop in kidney function (usually days or weeks) | Low urine output, worsening illness | Urgent medical evaluation |
| Nephrotic syndrome | Heavy protein in urine, low blood albumin levels | Severe swelling, weight gain | Urgent medical evaluation |
| Cardiovascular problems | Blood pressure, cholesterol, heart health assessment | Often none until advanced, then chest pain, breathlessness | Heart-healthy lifestyle and risk management |
High blood pressure
High blood pressure in IgA nephropathy is one of the most common complications. Healthy kidneys help regulate blood pressure by filtering out salt and extra fluid. When the filters are damaged, pressure rises, which further strains the filters, creating a vicious cycle. Bringing down high blood pressure is one of the most effective ways to protect kidney function.
Persistent proteinuria and kidney scarring
Protein leaking into your urine is a sign of kidney damage. Over time, proteinuria can cause further inflammation and scar tissue builds up at the site of inflammation, interfering with kidney function. Your doctor will monitor urine protein at most visits. Treatment focuses on lowering protein leakage with medications, healthy blood pressure control, and lifestyle changes.
Chronic kidney disease and kidney failure
Chronic kidney disease in IgA nephropathy is one of the most important complications doctors monitor for. Chronic kidney disease occurs when kidney function falls below the normal range, and early stages often have few or no symptoms. As it progresses, you may experience fatigue, swelling, cramps, and changes in urination.
Advanced chronic kidney disease can lead to kidney failure, which could eventually require a kidney transplant.
Kidney failure and kidney replacement therapy
Kidney failure in IgA nephropathy, or end-stage kidney disease, happens when the kidneys can no longer carry out enough of their normal function, requiring dialysis or transplant. Modern IgAN treatment aims squarely at delaying or preventing this. If it starts to look likely, your team usually discusses it with you months ahead, so there’s time to understand options.
Gross and microscopic hematuria
Visible blood in the urine is called gross hematuria, and it may make urine appear pink, dark red, or cola-colored. This is common if you have a cold or sore throat, and it usually clears up in a few days. However, doctors often are able to detect blood in the urine without visible changes; this is called microscopic hematuria. Ongoing hematuria in IgA nephropathy may indicate persistent inflammation.
Nephrotic syndrome
Occasionally, protein loss becomes heavy enough to cause nephrotic syndrome in IgA nephropathy, the core signs of which include very high urine protein, low blood protein, swelling, and high cholesterol. In IgAN, it tends to appear as puffiness that doesn’t diminish overnight, and it calls for a prompt call to your nephrology team. This variant of the disease is rare but carries a high risk of disease progression.
Cardiovascular risk
Kidney disease and heart disease tend to occur together. Reduced kidney function, raised blood pressure, and protein in the urine all add to cardiovascular risk in kidney disease. That’s why IgA nephropathy care may include cholesterol checks, questions about smoking, and blood pressure targets set with your heart health in mind.
Fluid retention and swelling
As kidney function changes or protein loss increases, the body may begin holding onto extra salt and water. This can lead to the following:
- puffy eyelids
- swollen feet and ankles
- sudden weight gain
- shortness of breath
Your healthcare provider may recommend limiting sodium, adjusting fluid intake in some situations, or prescribing diuretics to help remove excess fluid.
Treatment-related complications
Most medications used to treat IgA nephropathy are safe and effective when monitored properly, but they can have side effects. Steroids can raise blood sugar, blood pressure, and infection risk; medicines that quell the immune system also can raise infection risk. Blood pressure medicines that lower urine protein may nudge potassium up or shift kidney numbers slightly at first. These effects are expected, watched for, and often settled with a dose change.
How monitoring helps detect complications early
Routine monitoring and comparing results across visits are the best ways to prevent complications. Keeping follow-up appointments — even when you feel well — can make a big difference in protecting long-term kidney health.
When to get urgent medical care
Most changes with IgAN happen gradually, but some symptoms need immediate medical attention.
Get urgent medical care if you develop any of the following:
- uncontrolled high blood pressure
- severe swelling that appears suddenly
- difficulty breathing or shortness of breath
- very little or no urine output for a day
- chest pain or pressure
- severe weakness or confusion
- heavy bleeding in the urine along with severe pain, fever, or inability to urinate
Prompt evaluation can help identify serious complications and allow treatment to begin as quickly as possible. If you’re unsure, reaching out to your care team is always reasonable.
Learning about IgA nephropathy complications can feel overwhelming, but remember that these complications are possibilities — not certainties. Many people never experience severe kidney damage, especially when blood pressure, proteinuria, and other risk factors are carefully managed.
IgA Nephropathy News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
