Professor Jonathan Barratt
The Mayer Professor of Renal Medicine, University of Leicester
Thanks to ongoing research and clinical trials, promising new therapies are being evaluated for a kidney condition that affects young adults.
A debilitating kidney condition with no approved treatment is striking young adults.
IgA nephropathy (IgAN) is a progressive autoimmune disease which affects kidney function and results in up to half of patients developing ESRD (end-stage renal disease) and requiring haemodialysis or transplantation.
Tragically, there remains a risk that the condition may recur in a transplanted kidney. However, scientists and clinicians are hopeful since potential new treatments are being evaluated with several clinical trials currently under way.
Kidney failure risk
Consultant nephrologist Professor Jonathan Barratt explained that IgA nephropathy develops when the filters – or glomeruli – within the kidney that clean the blood become inflamed as a result of the protein IgA being deposited in them. This inflammation can cause further damage, ultimately leading to kidney failure.
Professor Barratt, who is a Professor of Renal Medicine at the University of Leicester and sees IgAN patients at Leicester General Hospital, says: “This disease affects young adults at a critical time in their life. We do not know what causes it and we have no treatment, but the likelihood of these patients to be on dialysis in their 40s is high, which makes the diagnosis really devastating.”
Currently, nephrologists work to control patient’s blood pressure, manage protein in the urine and slow the rate of kidney function deterioration. There is growing evidence that in IgAN the disease starts in the small intestine where structures called Peyer patches produce IgA1 antibodies and one new approach is to target the gut to reduce the amount of pathogenic IgA that is produced.
We do not really know what causes it and we have no treatment, but the likelihood is that these patients could be on dialysis in their 40s, which is an absolutely devastating diagnosis.
“This is an incredibly exciting time with potential treatments on the way,” Professor Barratt adds, pointing out that the UK is at the forefront of IgA Nephropathy research, with IgAN patients being offered the chance to participate.
Raise IgAN awareness
As the disease is relatively rare, the level of knowledge among health professionals is limited and patients find it hard to obtain relevant information.
“Most patients don’t even feel unwell with it,” Professor Barratt continues, “and often, it is only by chance that they come to our attention, when someone checks blood pressure, or identifies they have blood and protein in the urine.”
In the meantime, he stresses the need to raise awareness of the disease among the affected population and medical professionals.