IgA Nephropathy (Berger's Disease) in Children
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published NIDDK, ASN, AAP guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect iga nephropathy (berger's disease) in children, here is what the evidence says.
The short answer
IgA nephropathy (Berger's disease) is the most common type of glomerulonephritis worldwide. It occurs when IgA antibodies deposit in the kidneys, causing inflammation. A hallmark feature in children is visible blood in the urine (hematuria) that appears during or shortly after an upper respiratory infection. Most children with IgA nephropathy do well long-term, though some may develop chronic kidney disease over years to decades.
Key takeaways
- IgA nephropathy (Berger's disease) is the most common type of glomerulonephritis worldwide. It occurs when IgA antibodies deposit in the kidneys, causing inflammation. A hallmark feature in children is visible blood in the urine (hematuria) that appears during or shortly after an upper respiratory infection. Most children with IgA nephropathy do well long-term, though some may develop chronic kidney disease over years to decades.
- Usually normal when: Your child's urine appears dark or concentrated due to mild dehydration, and it clears up after drinking more fluids
- Call your doctor if: Your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
This is one of the most common questions parents ask. Searching for answers means you care.
What Parents Should Know
According to NIDDK, ASN, AAP guidelines, igA nephropathy (Berger's disease) is the most common type of glomerulonephritis worldwide. It occurs when IgA antibodies deposit in the kidneys, causing inflammation. A hallmark feature in children is visible blood in the urine (hematuria) that appears during or shortly after an upper respiratory infection. Most children with IgA nephropathy do well long-term, though some may develop chronic kidney disease over years to decades. At 0-2 years, igA nephropathy is extremely rare in infants and toddlers. Blood in the urine at this age is more likely related to urinary tract infections, structural abnormalities, or other conditions. Any visible blood in the urine in an infant or toddler should prompt immediate medical evaluation to determine the cause. It is generally considered normal when your child's urine appears dark or concentrated due to mild dehydration, and it clears up after drinking more fluids. However, you should contact your pediatrician promptly if your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis.
Normal vs. Concerning
When to Seek Immediate Care
- Your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis
- Your child has dark or bloody urine with decreased urine output, high blood pressure, or severe headache
- Your child is producing very little urine or no urine, which may suggest acute kidney injury
- Your child with known IgA nephropathy develops sudden worsening of hematuria with new symptoms such as swelling, fatigue, or difficulty breathing
By Age
What to expect by age
0-2 years
IgA nephropathy is extremely rare in infants and toddlers. Blood in the urine at this age is more likely related to urinary tract infections, structural abnormalities, or other conditions. Any visible blood in the urine in an infant or toddler should prompt immediate medical evaluation to determine the cause.
2-5 years
IgA nephropathy is uncommon but can occasionally present in this age group. The classic presentation is tea or cola-colored urine that appears during or within 1-2 days of a sore throat or upper respiratory infection (called synpharyngitic hematuria). This differs from post-streptococcal glomerulonephritis, which occurs 1-3 weeks after infection. If your child has dark-colored urine during a cold or sore throat, seek medical evaluation.
5-12 years
IgA nephropathy most commonly presents in older children and adolescents. Episodes of gross hematuria (visible blood in the urine) typically coincide with respiratory infections. Between episodes, microscopic hematuria (blood only visible on urine testing) may persist. A kidney biopsy is needed for definitive diagnosis. Treatment depends on severity: observation for mild disease, ACE inhibitors or ARBs if there is significant protein in the urine, and immunosuppressive therapy for more aggressive forms.
12 years+
Adolescence is a common time for IgA nephropathy to be diagnosed, often after recurrent episodes of gross hematuria with infections. Long-term prognosis depends on the amount of protein in the urine, blood pressure control, and kidney biopsy findings. ACE inhibitors are a cornerstone of treatment for those with proteinuria, as they reduce protein loss and help protect the kidneys. Regular monitoring of kidney function and blood pressure is important throughout life.
What to Tell Your Pediatrician
- Describe when you first noticed iga nephropathy (berger's disease) in children and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child's urine looks tea-colored, cola-colored, or pink during or shortly after a cold or sore throat.
- Mention if a routine urinalysis shows trace amounts of blood or protein even though your child seems well.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your child's urine appears dark or concentrated due to mild dehydration, and it clears up after drinking more fluids
- A urine test done at a routine checkup was completely normal with no blood or protein
- Your child had a brief episode of pink-tinged urine related to eating beets, berries, or certain food dyes
- Your child is well, growing normally, and has normal blood pressure
- Your child's urine looks tea-colored, cola-colored, or pink during or shortly after a cold or sore throat
- A routine urinalysis shows trace amounts of blood or protein even though your child seems well
- Your child has had more than one episode of dark or bloody-looking urine
- Your child has been diagnosed with IgA nephropathy and you have questions about monitoring or treatment
- Your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis
- Your child has dark or bloody urine with decreased urine output, high blood pressure, or severe headache
- Your child is producing very little urine or no urine, which may suggest acute kidney injury
- Your child with known IgA nephropathy develops sudden worsening of hematuria with new symptoms such as swelling, fatigue, or difficulty breathing
What You Can Do at Home
- Keep track of when you notice iga nephropathy (berger's disease) in children — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your child's urine appears dark or concentrated due to mild dehydration, and it clears up after drinking more fluids — this is generally within the range of normal.
- At 0-2 years, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis.
Related Conditions
baby blood in urine
Signs of a UTI in Babies
UTIs (urinary tract infections) in babies can be tricky to spot because symptoms are often vague - fever without other cold symptoms, fussiness, poor feeding, or foul-smelling urine. If your baby has unexplained fever, especially if under 3 months, your pediatrician may test for a UTI. UTIs need antibiotic treatment to prevent kidney damage.
Related Resources
Frequently asked questions
Is iga nephropathy (berger's disease) in children normal?
When should I call the doctor about iga nephropathy (berger's disease) in children?
When is iga nephropathy (berger's disease) in children normal?
What causes iga nephropathy (berger's disease) in children?
What should I mention to my pediatrician about iga nephropathy (berger's disease) in children?
Is iga nephropathy (berger's disease) in children normal at 0-2 years?
Is iga nephropathy (berger's disease) in children normal at 2-5 years?
Should I go to the ER for iga nephropathy (berger's disease) in children?
Does iga nephropathy (berger's disease) in children go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss IgA Nephropathy (Berger's Disease) in Children.
Things to mention
- Describe when you first noticed iga nephropathy (berger's disease) in children and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your child's urine looks tea-colored, cola-colored, or pink during or shortly after a cold or sore throat.
- Mention if a routine urinalysis shows trace amounts of blood or protein even though your child seems well.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your child's urine looks tea-colored, cola-colored, or pink during or shortly after a cold or sore throat
- A routine urinalysis shows trace amounts of blood or protein even though your child seems well
- Your child has had more than one episode of dark or bloody-looking urine
Urgent signs to report immediately
- Your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis
- Your child has dark or bloody urine with decreased urine output, high blood pressure, or severe headache
- Your child is producing very little urine or no urine, which may suggest acute kidney injury
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of iga nephropathy (berger's disease) in children are normal. Talk to your pediatrician if your child has visible blood in the urine along with significant swelling of the face or body, which could indicate a more aggressive form of glomerulonephritis.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
Was this page helpful?
Related Medical Concerns
Signs of a UTI in Babies
UTIs (urinary tract infections) in babies can be tricky to spot because symptoms are often vague - fever without other cold symptoms, fussiness, poor feeding, or foul-smelling urine. If your baby has unexplained fever, especially if under 3 months, your pediatrician may test for a UTI. UTIs need antibiotic treatment to prevent kidney damage.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.
Adrenoleukodystrophy (ALD) in Babies
X-linked adrenoleukodystrophy (X-ALD) is a genetic disorder affecting about 1 in 17,000 newborns, caused by mutations in the ABCD1 gene on the X chromosome. It primarily affects boys and impairs the breakdown of very long-chain fatty acids (VLCFAs), which accumulate and damage the myelin sheath in the brain and the adrenal glands. The most severe form, cerebral ALD, typically affects boys between ages 4-10 with rapid neurological decline. Newborn screening now enables early detection, and hematopoietic stem cell transplant or gene therapy performed before significant brain involvement can be life-saving.
How to Advocate for Your Child's Needs
You know your child better than anyone, and your observations matter. If you feel something is not right with your child's development or health, you have every right to ask questions, request evaluations, and seek second opinions. Advocating for your child is not being difficult - it is being a good parent.