Immunoglobulin-A nephropathy is the most common chronic glomerulonephritis worldwide. Metabolic risk factors, such as hyperuricaemia and hypertriglyceridaemia, are associated with the progression of IGA Nephropathy.

IGA Nephropathy prognosis
Although considered as a benign glomerulopathy, IgA nephropathy is now a well-known cause of end-stage renal disease (ESRD). Fifty percent of people suffering from gA nephropathy develop renal insufficiency and 20 to 30% may reach ESRD after 20 to 25 years of evolution.

Main Symptoms
Main symptoms are painless macrohematuria or microhematuria.

Natural Treatment of IgA Nephropathy
Treatment of IgA nephropathy with natural supplements has hardly been studied. I have listed a few supplements and herbs that have been looked at, but before starting an IgA nephropathy treatment program with these supplements, make sure you discuss with your doctor.

Fish oils are found in cold water fish and as supplements
Antioxidants such as Vitamins C, E, and Alpha Lipoic acid antioxidant
Cordyceps mushroom
White peony root herb
Perilla frutescens herb

One option is to try each IgA nephropathy treatment regimen for a period of 2 months, have a 2 week interval in between each one, and to see which one of these natural IgA nephropathy treatment options works best.

IGA Nephropathy Treatment Research Update
Oxidative stress and damage induced by abnormal free radical reactions and IgA nephropathy.
J Zhejiang Univ Sci B. 2005 Jan;6(1):61-8.
Chen JX, Zhou JF, Shen HC.
Division of Nephrology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou China.
To estimate the oxidative stress and oxidative damage induced by abnormal free radical reactions in IgA nephropathy patients' bodies. Seventy-two IgA nephropathy patients  and 72 healthy adult volunteers (HAV) were enrolled in a random control study design, in which the levels of nitric oxide (NO) in plasma, lipoperoxide (LPO) in plasma and in erythrocytes, and vitamin C (VC), vitamin E (VE) and beta-carotene (beta-CAR) in plasma as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes were determined with spectrophotometric methods. Compared with the HAV group, the averages of NO in plasma, and LPO in plasma and in erythrocytes in the IgA nephropathy group were significantly increased, while those of VC, VE and beta-CAR in plasma as well as those of SOD, CAT and GPX in erythrocytes in the IgA nephropathy group were significantly decreased. Linear correlation analysis showed that with the increase of the values of NO, and LPO in plasma and in erythrocytes, and with the decrease of those of VC, VE, beta-CAR, SOD, CAT and GPX in the IgAN patients, the degree of histological damage of tubulointerstitial regions was increased gradually; and that with the prolongation of the duration of disease the values of NO, and LPO in plasma and erythrocytes were increased gradually, while those of VC, VE, beta-CAR, SOD, CAT and GPX were decreased gradually. The discriminatory correct rates of the above biochemical parameters reflecting oxidative damage of the IgA nephropathy patients were 73%-92%, and the correct rates for the HAV were 70%-91% when independent discriminant analysis was used; and the correct rate for the IgA nephropathy patients was increased to 98%, the correct rate for the HAV was increased to 100% when stepwise discriminant analysis was used. CONCLUSIONS: A series of free radical chain reactions caused serious pathological aggravation in the IgA nephropathy patients'  bodies, thus resulting in oxidative damage in their bodies. In treating IgA nephropathy, therefore, it is necessary that suitable dose antioxidants should be supplemented to them so as to alleviate the oxidative damage in their bodies.

Docosahexaenoic acid attenuates mycotoxin-induced immunoglobulin a nephropathy, interleukin-6 transcription, and mitogen-activated protein kinase phosphorylation in mice.
J Nutr. 2004 Dec;134(12):3343-9.
Jia Q, Zhou HR, Bennink M, Pestka JJ.
Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
The purpose of this investigation was to evaluate the dose-dependent effects of docosahexaenoic acid (DHA) on deoxynivalenol (DON)-induced IgA nephropathy in mice and their relation to proinflammatory gene expression and mitogen-activated protein kinase (MAPK) activation. Taken together, the results indicate that DHA dose-dependently inhibited DON-induced IgA dysregulation and nephropathy, and that impairment of MAPK activation and expression of COX-2 and IL-6 are potential critical upstream mechanisms.

Treatment of severe IgA nephropathy with omega-3 fatty acids: the effect of a "very low dose" regimen.
Ren Fail. 2004 Jul;26(4):453-9.
The effect of a "very low dose" of purified omega-3 fatty acids (PFA) in the progression of severe IgA nephropathy was tested, in a randomized, prospective, controlled trial. Fourteen patients were assigned to receive a "very low dose" of PFA (0.85 g EPA and 0.57 g PHA) and 14 patients were treated symptomatically and used as controls. Both groups were similar in terms of serum creatinine (Scr) and glomerular filtration rate (GFR) at baseline. Patients were treated for 4 years. CONCLUSIONS: A "very low dose" of PFA is also effective in slowing renal progression in high-risk patients with IgA Nephropathy and particularly those with advanced renal disease.

Effect of 12-month therapy with omega-3 polyunsaturated acids on glomerular filtration response to dopamine in IgA nephropathy.
Am J Nephrol. 2004 Sep-Oct;24(5):474-82. Epub 2004 Sep 1.
Omega-3 polyunsaturated acids therapy is efficient in primary IgA nephropathy. It is unknown whether doses of omega-3 smaller than those given previously are still effective. The aim of the study was to examine the effect of omega-3 therapy on renal vascular function in relation to proteinuria and urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG). METHODS: 20 IgA Nephropathy patients aged 36.5 +/- 10 with creatinine clearance (Cr(cl)) 105 +/- 27 ml/min and proteinuria 3 +/- 2 g/24 h were given orally 810 mg EPA and 540 mg DHA daily for 12 months. Omega-3 supplementation is associated with the improvement of both renal vascular function and tubule function in IgA Nephropathy patients.

Oxidized omega-3 fatty acids inhibit pro-inflammatory responses in glomerular endothelial cells.
Nephron Exp Nephrol. 2004;97(4):e136-45.
Chaudhary A, Mishra A, Sethi S.
Department of Pathology, University of Iowa of Iowa Hospitals and Clinics, Iowa City, Iowa
Omega-3 fatty acids have beneficial effects in chronic inflammatory diseases that are characterized by accumulation of leukocytes and leukocyte-mediated tissue injury. Accumulation of leukocytes occurs, in part, due to pro-inflammatory responses in endothelial cells, such as increase in expression of leukocyte adhesion receptors and chemokines, such as MCP-1 and IL-8. These studies show that the beneficial effects of fish oil in chronic inflammatory diseases, including IgA nephropathy, may result from the inhibitory effects of oxidized omega-3 fatty acids on pro-inflammatory events in endothelial cells via inhibition of NF-kappaB activation.

Docosahexaenoic acid and eicosapentaenoic acid, but not alpha-linolenic acid, suppress deoxynivalenol-induced experimental IgA nephropathy in mice.
J Nutr. 2004 Jun;134(6):1353-61.
Jia Q, Shi Y, Bennink MB, Pestka JJ.
Department of Food Science and Human Nutrition, and Center for Integrative Toxicology, Michigan State University, East Lansing, MI
Diets enriched in the (n-3) PUFAs, docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and their precursor alpha-linolenic acid (ALA), were evaluated for efficacy in ameliorating the development of IgA nephropathy induced in mice by the mycotoxin deoxynivalenol (DON). Taken together, both DHA and EPA, but not ALA, ameliorated the early stages of IgA Nephropathy, and these effects might be related to a reduced capacity for IL-6 production.

The role of fish oil/omega-3 fatty acids in the treatment of IgA nephropathy.
Semin Nephrol. 2004 May;24(3):225-43.
Donadio JV, Grande JP.
Division of Nephrology, the Department of Medicine, and the Department of Laboratory Medicine and Pathology, Mayo Clinic & Mayo Foundation, Rochester, MN
Fish and marine oils are the most abundant and convenient sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the two major n-3 fatty acids that serve as substrates for cyclooxygenase and lipoxygenase pathways leading to less potent inflammatory mediators than those produced through the n-6 PUFA substrate, arachidonic acid. N-3 PUFA can also suppress inflammatory and/or immunologic responses through eicosanoid-independent mechanisms. Although the pathophysiology of IgA nephropathy is incompletely understood, it is likely that n-3 PUFA prevents renal disease progression by interfering with a number of effector pathways triggered by mesangial immune-complex deposition. In addition, potential targets of n-3 PUFA relevant to renal disease progression could be similar to those involved in preventing the development and progression of cardiovascular disease by lowering blood pressure, reducing serum lipid levels, decreasing vascular resistance, or preventing thrombosis. In IgA nephropathy, efficacy of n-3 PUFA contained in fish oil supplements has been tested with varying results. The largest randomized clinical trial performed by our collaborative group provided strong evidence that treatment for 2 years with a daily dose of 1.8 g of EPA and 1.2 g of DHA slowed the progression of renal disease in high-risk IgA Nephropathy patients. These benefits persisted after 6 years of follow up.

Pathogenesis of IgA nephropathy.
Semin Nephrol. 2004 May;24(3):197-217.
In IgA nephropathy, there is dysregulation of the IgA response to a wide range of antigens. The dysregulation promotes synthesis of polymeric IgA1 (pIgA1) with physicochemical characteristics that favor mesangial deposition, including altered O-glycosylation of the hinge region. This may be the synthesis of IgA in the systemic compartment, which has the phenotype of mucosal IgA. There is not a change in IgA1 structure to an entirely abnormal form; rather, there is a shift that results in a proportional increase in forms of IgA1 also found in healthy individuals. Altered O-glycosylation could favor pIgA1 deposition by promoting formation of macromolecular IgA and immune complexes. Mesangial injury follows through interactions of pIgA1 with the cells and extracellular matrix proteins of the mesangium and the activation of complement. The final clinical expression of IgA Nephropathy also depends on generic factors, including hypertension and proteinuria, and a fibrotic renal response. No single IgA Nephropathy gene has been identified, and it is likely that multiple interacting genes will eventually prove to underlie susceptibility to IgA Nephropathy and the risk of progressive renal disease.

Effect of fish oil on oxidative stress, lipid profile and renal function in IgA nephropathy.
J Med Assoc Thai. 2004 Feb;87(2):143-9.
The omega-3 polyunsaturated fatty acids in fish oil have been shown to produce beneficial effects, such as a reduction in blood pressure, proteinuria, lipid levels and inflammation. Aggregated immunoglobulin A obtained from IgA nephropathy patients induced greater oxygen free radicals in polymorphonuclear leukocytes than other glomerulopathy. All of which may affect the course of IgA nephropathy. Twenty-three adult patients with biopsy proven IgA nephropathy, with proteinuria more than 1 g/day, serum creatinine less than 3 mg/dl and blood pressure control less than 130/80 mmHg were given omega-3 polyunsaturated fatty acids (PUFA) in the form of an Omacor capsule 4 g/day equivalent to eicosapentaenoic acid (EPA) 1.88 g and docosahexaenoic acid (DHA) 1.48 g for 6 months. A 3 to 6 month follow-up was planned. By six months, the serum triglyceride was significantly reduced. There was a trend of increased serum high density lipoprotein (HDL)-cholesterol. Urine beta-2-microglobulin was elevated in IgA patients and decreased statistically significant after 3 months and 6 months of fish oil therapy. Plasma malondialdehyde (MDA), the end product of oxidative stress was statistically, significantly decreased. The study did not show any change in blood pressure, proteinuria, or serum creatinine. The authors conclude from the results of this study that patients with idiopathic IgA nephropathy with proteinuria and mildly reduced GFR did not benefit from short-term treatment with 4 g per day of omega-3 PUFA regarding the total protein excretion and glomerular filtration rate (GFR), but the advantage was the improvement in tubular dysfunction, lipid profiles, and oxidative stress.

[Clinical study on dan shao tang in treating IgA nephropathy of deficiency of yin with damp-heat symptom]
Zhong Yao Cai. 2003 Nov;26(11):844-6.
To explore the effect of Dan Shao Tang in treating IgA nephropathy of deficiency of Yin with damp-heat symptom. METHODS: 90 patients with IgA nephropathy of deficiency of Yin with damp-heat symptom were randomly divided into two groups. 50 patients in treatment group were treated with Dan Shao Tang and western medicine and 40 patients in control group were treated only with western medicine. The effects and changes of the indexes including renal function, hematuria, proteinuria, blood IgA before and after treatment were observed. After six months treatment, the general effective rate in treatment group was 70%, which was markedly higher than that in control group. Treatment group is obviously better than control group on decreasing hematuria, proteinuria, blood IgA and improving renal function. CONCLUSION: Dan Shao Tang is effective on IgA nephropathy of deficiency of Yin with damp-heat symptom.

[The effect of the extract from Radix Paeoniae alba on IgA Glomerulonephritis in mice]
Zhong Yao Cai. 2003 Feb;26(2):109-11.
To observe the effect of the extract from Radix Paeoniae Alba ( white peony root )on IgA glomerulonephritis in mice. METHODS: IgA glomerulonephritis was induced by injection of dextran and sephadex-150. After administrating the extract, the contents of urinary protein, BUN and Cr in serum were determined. RESULTS: The extract could inhibit the decline of mouse weight, and decrease urinary protein content and BUN content in serum. While, the extract had no effect on Cr in serum. CONCLUSION: The extract from Radix Paeoniae Alba had therapeutical effect on IgA glomerulonephritis.

Suppressive effects of Perilla frutescens on IgA nephropathy in HIGA mice.
Nephrol Dial Transplant. 2003 Mar;18(3):484-90.
Perilla frutescens (perilla) is a herbal medicine used in Japanese traditional Kampo medicine. The present study was conducted to evaluate the anti-nephritic effects of perilla in HIGA mice that spontaneously develop high levels of serum immunoglobulin A (IgA) along with mesangial IgA deposition. METHODS: A perilla decoction and its major active constituent, rosmarinic acid (RsA), were orally administrated to 10-week-old HIGA mice for 16 weeks. RESULTS: Perilla suppressed proteinuria, proliferation of glomerular cells, serum levels of IgA, glomerular IgA and IgG depositions in HIGA mice. Cultured Peyer's patch cells and spleen cells from perilla-treated mice produced significantly less IgA than controls. Rosmarinic acid, by itself, suppressed serum IgA levels and glomerular IgA deposition in HIGA mice. Cultured spleen cells from RsA-treated mice produced less IgA than controls. CONCLUSIONS: The perilla decoction may suppress IgA nephropathy, in part, through modulation of the intestinal mucosal immune system. These effects were caused by rosaminic acid acting synergistically with other constituents.

[Clinical study on Shenning Mixture in treating IgA nephropathy]
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000 Oct;20(10):729-30.
To study the clinical therapeutic effect of Shenning Mixture (SNM) in treating IgA nephropathy. METHODS: Patients were treated separately with SNM or prednisone by randomized grouping. The criteria, including clinical symptoms, signs, hematuria, albuminuria and immune globulin were observed. RESULTS: The total effective rate and the complete remission rate in the SNM group were 97% and 45% respectively, while in the control group, they were 37% and 8% respectively. Comparison of the two groups showed that the therapeutic effect in the former was better than that in the latter significantly. The hematuria and albuminuria extenuated and serum IgA lowered more significantly in the SNM group than those in the control group. CONCLUSION: SNM has obvious therapeutic effect on the hematuria and albuminuria in treating IgA nephropathy.

Dietary fish oil suppresses experimental immunoglobulin a nephropathy in mice.
J Nutr. 2002 Feb;132(2):261-9.
Dietary fish oil (FO) supplementation reportedly retards the progression of renal disease in patients with immunoglobulin IgA nephropathy, the most common glomerulonephritis worldwide. Using an experimental mouse model in which early immunopathological hallmarks of IgA Nephropathy are induced by the mycotoxin vomitoxin (VT), the ameliorative effects of FO ingestion on this disease were evaluated in two studies. In Study 1, the capacity of VT to induce IgA Nephropathy was evaluated in mice fed for 12 wk AIN-76A diets containing 50 g/kg corn oil (CO), 50 g/kg CO plus 9 mg/kg tert butylhydroquinone (TBHQ), or 5 g/kg CO plus 45 g/kg menhaden FO that contained 200 mg/kg TBHQ. Serum IgA, serum IgA immune complexes and kidney mesangial IgA deposition were greater in mice fed VT + CO compared with the CO control group, whereas all three variables were significantly attenuated in mice fed VT + FO. In Study 2, the effects of feeding modified AIN 93G diets containing either 70 g/kg CO or 10 g/kg CO plus 60 g/kg FO for 20 wk on VT-induced IgA Nephropathy were compared. Again, consumption of FO attenuated all three immunopathological variables. In addition, spleen cell cultures from the VT + FO group produced markedly less IgA than those cultures from mice fed VT + CO. Taken together, the results suggested that diets containing fish oil may impair early immunopathogenesis in VT-induced IgA Nephropathy and that this was not totally dependent on the presence of the antioxidant TBHQ.

[Effect of Yiqi Zishen granule on ultrastructure of glomeruli of IgA nephropathy in mice]
Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Dec;19(12):737-9.
To study the effect and therapeutical mechanism of Yiqi Zishen granule (YQZSG) in treating IgA nephropathy. One hundred and fifty mice were divided into 5 groups randomly, in every treatment group, the relevant drugs were given. RESULTS: The glomerular mesangial cells and mesangial matrix were proliferative in the model group at the 6th, 9th and 12th week. The light density of glomeruli, the mesangial area, the numeral density of mesangial cells and the light density of mesangial matrix in the model group were obviously higher, the change of large and small dosage YQZSG group and positive Chinese drug group were similar, but milder in pathological degree. CONCLUSION: YQZSG could inhibit the proliferation of mesangial cells and the mesangial matrix in IgA nephropathy.

The long-term outcome of patients with IgA nephropathy treated with fish oil in a controlled trial. Mayo Nephrology Collaborative Group.
J Am Soc Nephrol. 1999 Aug;10(8):1772-7.
Donadio JV Jr, Grande JP, Bergstralh EJ, Dart RA, Larson TS, Spencer DC.
Department of Internal Medicine, Mayo Clinic & Foundation, Rochester, Minnesota
It was reported previously that dietary fish oil supplementation retarded the progression of renal disease in patients with IgA nephropathy in a multicenter, placebo-controlled, randomized, 2-yr clinical trial. The aim of this study was to determine the long-term influence of fish oil treatment on renal progression in observations on the study cohort of 106 patients extending beyond the 2-yr trial. After a mean follow-up of 6.4 yr, 46 patients-17 in the fish oil group versus 29 in the placebo group-reached the primary end point, and 27 patients-eight in the fish oil group versus 19 in the placebo group-developed ESRD. At the end of the 2-yr trial, 75 patients (45 fish oil, 30 placebo) remained at risk for the primary end point. This is also when the double-blind part of the trial ended, allowing physicians to stop supplements, switch original placebo-assigned patients to fish oil, and continue fish oil in original fish oil-assigned patients. A significantly greater number of nonsupplemented placebo patients developed the primary end point and ESRD compared with long-term supplemented fish oil patients. By intention, BP control, primarily treated with angiotensin-converting enzyme inhibition, was equal in the fish oil and placebo groups. Proteinuria was modestly reduced in both groups. It is concluded that early and prolonged treatment with fish oil slows renal progression for high-risk patients with IgA nephropathy.

Inhibition of activated human mesangial cell proliferation by the natural product of Cordyceps sinensis (H1-A): an implication for treatment of IgA mesangial nephropathy.
J Lab Clin Med. 1999 Jan;133(1):55-63.
Cordyceps sinensis is a parasitic fungus that has been used as a Chinese medicine for a long time in the treatment of nephritis. Today, the hypothesis about the pathogenesis of immunoglobulin A nephropathy is that nephritogenic IgA immune complexes (IgAIC) go to the kidney to stimulate resting mesangial cells to release cytokines and growth factors. These cytokines and growth factors cause mesangial cell proliferation and release matrix, chemical mediators that lead to the glomerular injury. However, nephritogenic IgAIC in humans is still unknown. To solve this problem previously, we established an in vitro model that showed that cultured human mesangial cells (HMC) stimulated with interleukin-1 (IL-1) plus IL-6 can cause mesangial cell proliferation, increasing production of chemical mediators and superoxide anion. An in vivo model also proved that this culture medium may lead to renal injury with hematuria and proteinuria. These results give us a new regimen for the treatment of patients with IgA Nephropathy in the future. iga nephropathy bergers disease cause of iga nephropathy.

Managing Henoch-Schonlein purpura in children with fish oil and ACE inhibitor therapy.
Nephrology (Carlton). 2004 Dec;9(6):381-6. Dixit MP, Dixit NM, Scott K.
Department of Pediatrics, Steele Memorial Children's Research, University of Arizona, Tucson, Arizona
The kidney biopsy in Henoch-Schonlein purpura shows IgA deposits and fish-oil therapy has proven to be promising in halting the progression of IgA nephropathy. Five children with biopsy-proven HSP with repeated episodes of haematuria and proteinuria were treated with fish oil (1 g orally twice daily). In three of the five patients an angiotensin-converting enzyme inhibitor (ACEI) was added for hypertension. This is the first report of abatement of Henoch-Schonlein purpura with fish oil and ACEI in children. There is a need for randomized prospective trials to confirm this observation.