Managing Blood Pressure With IgA Nephropathy
To understand why blood pressure management matters so much with IgAN, it’s helpful to examine what happens inside the kidneys.
Kidney Damage Can Raise Blood Pressure
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Dr. Voora suggests thinking of glomeruli as microscopic mesh filters. These filters remove waste and excess fluid from your blood while keeping important substances, such as protein, from leaking out.[5]
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The immune system sees this abnormal IgA as a threat and creates antibodies to attack it, says Yasir Qazi, MD, a transplant nephrologist with Providence St. Joseph Hospital in Orange, California.[3]
As the damage progresses, the filters become less effective at removing excess fluid and sodium from the body, which can lead to high blood pressure.[6]
At the same time, higher blood pressure means blood is pushing through the kidneys’ filters with greater force. Voora compares that force to a power washer hitting a delicate mesh screen. The added pressure can tear and damage the filters even further, increasing kidney damage, she says.
High Blood Pressure Can Cause Excess Protein in Urine
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“High levels of protein leakage are the strongest indicator that the disease is active, the kidneys are under stress, and there is a higher risk of progression toward dialysis, if not addressed,” says Voora.
Kidney Scarring Can Occur
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The problem is that once a filtering unit becomes scarred, known as glomerulosclerosis, it loses its blood supply and can no longer function properly, says Voora.
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“To compensate, these healthy filters dilate and experience even higher blood pressure and filtration demands, leading to burnout and faster scarring,” Voora explains.[10]
Dr. Qazi says that this creates a cycle in which high blood pressure causes kidney scarring, and kidney scarring causes blood pressure to rise.[11]
