IgA nephropathy (also known as Berger's disease) is the commonest cause of glomerulonephritis worldwide. It classically presents as macroscopic haematuria in young people following an upper respiratory tract infection.


  • Incidence: 3.00 cases per 100,000 person-years
  • Peak incidence: 20-30 years
  • Sex ratio: more common in males 3:1
Condition Relative
Henoch-Schonlein purpura3.33
IgA nephropathy1
Post-streptococcal glomerulonephritis0.10
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+


Associated conditions


  • thought to be caused by mesangial deposition of IgA immune complexes
  • there is considerable pathological overlap with Henoch-Schonlein purpura (HSP)
  • histology: mesangial hypercellularity, positive immunofluorescence for IgA & C3

Clinical features

  • young male, recurrent episodes of macroscopic haematuria
  • typically associated with mucosal infections e.g., URTI
  • nephrotic range proteinuria is rare
  • renal failure is unusual and seen in a minority of patients

Differential diagnosis

Differentiating between IgA nephropathy and post-streptococcal glomerulonephritis
  • post-streptococcal glomerulonephritis is associated with low complement levels
  • main symptom in post-streptococcal glomerulonephritis is proteinuria (although haematuria can occur)
  • there is typically an interval between URTI and the onset of renal problems in post-streptococcal glomerulonephritis


  • steroids/immunosuppressants not be shown to be useful


  • 25% of patients develop ESRF
  • markers of good prognosis: frank haematuria
  • markers of poor prognosis: male gender, proteinuria (especially > 2 g/day), hypertension, smoking, hyperlipidaemia, ACE genotype DD

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