Answer:

Berger's disease, also known as IgA nephropathy, occurs when a protein called immunoglobulin A (IgA) builds up in the kidneys' filtering units (glomeruli), causing inflammation. Over time, this can affect the kidneys' ability to filter blood and remove waste products from the body.

Common symptoms include tea-colored or bloody urine, foamy urine (proteinuria), back or flank pain, fatigue, swelling, and high blood pressure. If the disease progresses to kidney failure, it can cause skin rashes, itching, muscle cramps, abdominal pain, and vomiting.

The exact cause of IgA buildup in the kidneys is unknown. However, several risk factors include genetics, liver disease, celiac disease, infections (such as HIV or certain bacterial infections), and a family history of the disease.

Berger's disease typically progresses slowly, but the course of the disease varies from person to person. Some individuals may have the disease for years with minimal problems. Others may develop complications such as swelling and high blood pressure due to IgA buildup. High blood pressure can further damage the kidneys. Elevated cholesterol levels increase the risk of heart disease and other cardiovascular issues.

Doctor Vo Thi Kim Thanh examines a patient. Photo: *Tam Anh General Hospital*

Some individuals experience acute kidney failure due to a rapid increase in waste products in the blood, leading to a decline in kidney function. More seriously, if kidney function continues to decline without detection and treatment, it can lead to end-stage renal disease, requiring dialysis or a kidney transplant for survival.

Berger's disease can also cause nephrotic syndrome, characterized by high levels of protein in the urine (proteinuria), low levels of albumin in the blood, and elevated blood lipids. This can lead to swelling in the eyelids, feet, abdomen, and throughout the body.

While Berger's disease cannot be completely cured, early detection and treatment can help manage the condition. Treatment options include medications to control blood pressure (if elevated), omega-3 supplements, immunosuppressants, statins to lower cholesterol, and diuretics (if swelling is present). These treatments can slow the progression of the disease.

Patients should also adopt supportive measures to manage their blood pressure by limiting salt intake, alcohol, stimulants, and tobacco. Depending on the stage of the disease, reducing protein and fat in the diet is also recommended. Maintaining a healthy lifestyle, including regular exercise and a healthy weight, is crucial. To prevent Berger's disease, individuals should take precautions against hepatitis B, treat hepatitis C (if present), and avoid infections.

In your case, to determine the severity of your condition, it is essential to consult a doctor for a thorough kidney evaluation. This may include blood tests (creatinine, urea, glomerular filtration rate or GFR), ultrasound, CT scan, or a kidney biopsy to determine the specific type of Berger's disease. Based on the results, the doctor can develop an appropriate treatment plan and provide a more accurate prognosis.

Associate Professor, Doctor Vo Thi Kim Thanh

Deputy Head of Nephrology - Dialysis Department

Urology - Nephrology - Andrology Center

*Tam Anh General Hospital*, TP HCM