What is it
                                        Who will be affected
                                        What are the symptoms
                                        What is the natural course
                                        What is the treatment

What is it?

    This is the most common variety of Chronic Glomerulonephritis worldwide.  It is also known as Berger's disease. IGA nephropathy (IgAN) is characterized by deposition of a protein called IgA (Immunoglobulin-A) in the kidneys.  Most of the time IgAN occurs as a primary disease and not as a secondary manifestation of another disease.   Occasionally it may occur as a secondary manifestation of the following disease states:

               1.  Liver Disease (Cirrhosis)
                2.  Enteropathy
                3.  Arthritis
                4.  Dermatitis (Herpitiformis)
                5.  Henoch-Schonlein Purpura (HSP)

Who will be affected?

               1.  Most common in Asia ( >50% of all Primary Glomerulonephritis)
                2.  Accounts for 20 to 30% of all Glomerulonephritis in Europe*
                3.  In USA 10 to 15% of all Primary Glomerulonephritis are IgAN
                4.  Rare in African-Americans and Africans
                5.  More common in Native Americans in southwest (35%)
                       ____________________________________________________
                    * In Japan and France where testing for the condition is part of 
                       regular preventive medical care the incidence is twice that found 
                       in the USA where testing for IgAN is not performed as part of 
                       preventive medicine. 

What are the symptoms?

            1.  Usually none
            2.  Blood in the urine (Hematuria) seen only when urine is tested
            3.  Visibly bloody urine
            4.  Symptoms of Proteinuria
            5.  Frequent urge to urinate

What is the natural course?

           1.  Natural course is quite variable with upto 25% remitting 
                  spontaneously without any treatment.
            2.  In others Chronic Renal Failure develop over a long period
                 of time (10 to 20 years)
            3.  Such chronic renal failure may progress to End Stage Renal failure
                 requiring dialysis or kidney transplant in 20 to 30% in 10  to 20 yrs.
            4.  Unpredictable rapid deterioration of kidney function may occur rarely
            5.  The following factors portend adverse outcome:
                        a.  Poorly functioning kidney at the time of initial diagnosis
                        b.  Proteinuria of more than 3000 mgs in 24 hrs
                        c.  Presence or development of Hypertension

What is the treatment?

            1.  No proven treatment is available.
             2.  When there is minimal protein in the urine (<1000 mgs/24 hrs) or 
                 when the protein in the urine is >1000 but <3000mgs/24hrs and
                 the kidney function (Creatinine Clearance) is normal,  it is prudent
                 to observe without any treatment.
             3. When the protein in the urine is >1000 but <3000mgs/24hrs and
                 the kidney function (Creatinine Clearance) is reduced or when
                 the protein in the urine is >3000 mgs/24hrs, since there is no
                proven treatment, experimental  treatment with the following medications
                may be undertaken:
                        a.  Prednisone and Cytoxan
                        b.  Fish Oil Capsules
                        c.  ACE-Inhibitors or ARBs for proteinuria
            4.  Treat hypertension if present
            5.  Protein restricted diet may be of some help
            6.  Tonsillectomy has been attempted to influence the immune system