IgA Nephropathy, also known as Berger’s disease, is one of the most common forms of primary glomerulonephritis worldwide and a significant cause of chronic kidney disease. It is characterized by abnormal deposition of immunoglobulin A (IgA) within the glomeruli, leading to inflammation, scarring, and progressive loss of kidney function over time. The disease affects both adults and younger individuals and shows a highly variable clinical course.

The underlying mechanism involves dysregulation of the immune system, resulting in production of structurally abnormal IgA molecules. These IgA molecules form immune complexes that deposit in the glomerular mesangium, triggering inflammatory pathways and gradual damage to the kidney’s filtering units. Repeated inflammatory episodes contribute to fibrosis and irreversible nephron loss.

Clinically, IgA nephropathy most commonly presents with hematuria, which may be microscopic or visible to the naked eye. Episodes of blood in the urine often occur following respiratory or gastrointestinal infections. Proteinuria is another important feature and is closely associated with disease progression. As the condition advances, patients may develop hypertension, swelling, and declining kidney function.

Diagnosis requires a kidney biopsy, which demonstrates mesangial IgA deposition on immunofluorescence microscopy. Blood and urine tests are used to assess disease severity, kidney function, and response to treatment. Imaging studies help exclude alternative causes of kidney dysfunction.

Management focuses on slowing disease progression and preserving kidney function. Blood pressure control and reduction of proteinuria are central to treatment. Lifestyle modification, dietary measures, and long-term monitoring are essential components of care. In selected patients with active inflammatory disease, immunosuppressive therapy may be considered. Regular nephrology follow-up is critical, as disease progression may occur silently over years.
The prognosis of IgA nephropathy varies widely. Some patients maintain stable kidney function for decades, while others progress to end-stage kidney disease. Early diagnosis, appropriate risk stratification, and consistent long-term management significantly improve outcomes.