When your kidneys aren’t functioning as well as they used to due to IgA nephropathy (IgAN) or complement 3 glomerulopathy (C3G), the effects can echo throughout your body. A change in your medication regimen — more of some, fewer of others — can help restore balance.
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Nephrologist Corey Canaugh, DO, shares what you can (and can’t) expect to find in your medicine cabinet after an IgAN or C3G diagnosis.
What your doctor may recommendThe medications your provider suggests for keeping your whole body healthy when you’re living with IgAN or C3G depend on how severe your condition is and the symptoms you’re experiencing.
The goal? Ensuring your body gets what it needs while keeping side effects to a minimum.
“Your kidneys do a lot of great things, so when they’re not functioning as well as they should, your provider will probably look to supplement some of that function with medication,” Dr. Canaugh says.
Depending on your symptoms and your disease progression, he adds that your provider may suggest medications to help perform some of your kidneys’ essential functions.
Medications can do things like:
Control acid buildupOur bodies (and the food we eat) naturally produce acid. One of your kidneys’ jobs is to help clear that acid. When your kidneys aren’t working well, the acid builds up in your body, a condition called metabolic acidosis.
That extra acid can cause symptoms like fatigue, confusion, loss of appetite and more. Over time, the excess acid can wear away at your bones, causing renal osteodystrophy, a condition associated with bone pain and fractures.
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As you may he learned in chemistry class, bases neutralize acids. So, your provider may recommend a base, like sodium bicarbonate or sodium citrate, to reduce the acid buildup and protect your bones.
Manage anemiaIf you he IgA nephropathy or C3G, your provider may recommend synthetic erythropoietin therapy or iron supplements to reduce your risk of anemia (a low number of healthy red blood cells).
“Your kidneys make a hormone called erythropoietin, which tells your bones to make red blood cells,” Dr. Canaugh explains. “When you he kidney disease, you may not make enough erythropoietin, or you may be less sensitive to it, which leads to anemia.”
Classic symptoms of anemia include:
Feeling tired, weak or like you might faintShortness of breathHeadachesPale skinSweatiness, dizziness or lightheadednessKeep blood pressure in checkYour provider may prescribe medication to lower your blood pressure. That’s important because high blood pressure can both cause and be caused by kidney diseases like IgAN and C3G.
Your kidneys are responsible for filtering sodium from your body. When you he kidney disease, sodium builds up. It raises your blood pressure, which can lead to heart attack, stroke, eye damage and more.
Common blood pressure medications include:
Angiotensin-converting enzyme inhibitors (ACE inhibitors)Angiotensin II receptor blockers (ARBs)Thiazides or loop diuretics (“water pills”)Calcium channel blockers (CCBs)Remove protein from urineSome medications, called renin-angiotensin system (RAS) inhibitors, may be used to treat high blood pressure and protein in the urine (proteinuria), a classic finding in both IgA nephropathy and C3G.
“RAS inhibitors are some of our first-line medications for treating both high blood pressure and proteinuria,” Dr. Canaugh notes.
A class of medications originally intended to treat people with diabetes is also gaining traction for use in people with kidney disease. They’re called SGLT2 inhibitors, and they go by names like:
Canagliflozin (Invokana®)Dapagliflozin (Farxiga®)Empagliflozin (Jardiance®)“Aside from reducing protein in the urine, they protect your kidneys by decreasing the pressure in the nephron, which is where the blood filtration process starts,” he adds.
Suppress immune responseIgA nephropathy and C3G are both autoimmune diseases, so your provider may prescribe immunosuppressants to improve your kidney function.
If you think of your immune system like a pot of water on the stove, it’s generally set to a simmer. When you he an infection, your immune system turns up the heat to defend against the threat. When the infection clears, it returns to a slow boil.
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When you he an autoimmune disorder, the burner is stuck on high heat. Your immune system is creating loads of IgA protein to fight off bacteria and viruses. But there aren’t any germs to fight off. So, that IgA builds up in your kidneys.
Dr. Canaugh says providers may prescribe immunosuppressant medications — typically, steroids like prednisone — to turn down the heat on your burner. Steroids reduce your immune response, giving your kidneys a chance to do their work without being overloaded with IgA.
“In the short term, steroids can help inflammation and calm things down,” he continues. “But prolonged use can cause some pretty serious side effects that we try to oid.”
Among the side effects associated with steroids are:
A lowered ability to fight infectionsBone lossCataractsDiabetesInsomniaPoor wound healingWeight gainSome newer steroids attempt to suppress immune system response with fewer side effects.
Medications to oid or limitIn addition to taking new medications, your provider will likely counsel you to eliminate or oid other medications to protect your kidney function.
NSAIDsWhen you’re living with IgA nephropathy, C3G or other kidney diseases, you should oid nonsteroidal anti-inflammatory medications (NSAIDs) entirely, as they can damage even healthy kidneys.
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Common NSAIDs include:
Ibuprofen (known by brand names such as Motrin® and Advil®)Naproxen sodium (known by the brand name Aleve®)AspirinCertain heartburn medsMedications called proton-pump inhibitors that are used to treat ulcers and heartburn may be too risky when you he IgA nephropathy, C3G or another kidney disease.
Common proton-pump inhibitors include medications that end in “-ole” like:
Esomeprazole (Nexium®)Lansoprazole (Prevacid®)Omeprazole (Prilosec®)Pantoprazole (Protonix®)Rabeprazole (AcipHex®)IV contrastIf you’re going to he a medical procedure like a CT scan, cardiac catheterization or another test that uses IV contrast dye, make sure your provider knows you he kidney disease. They may need to adjust the type or amount of dye you receive or he other instructions for you to follow related to your procedure.
Final thoughtsMedication needs may differ from person to person based on the kidney disease you he and how it impacts your body and your life. Your provider will monitor you closely and discuss strategies and options.
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