IgAN and Steroids: Benefits, Risks, and Side Effects to Know About
Published on April 13, 2026
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When you have IgA nephropathy (IgAN), a rare kidney disease that can lead to kidney damage or failure, the goal of treatment is to keep your kidneys working well for as long as possible. This usually starts with supportive care, such as medications to control blood pressure and lifestyle changes.
IgAN, also called Berger’s disease, can cause your kidneys to leak blood (hematuria) and protein (proteinuria) into your pee.If supportive care doesn’t lower proteinuria enough, your doctor may recommend starting a course of steroids, sometimes called glucocorticosteroids or corticosteroids.
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Read MoreHow Steroids Work
Steroids are medications that help reduce inflammation in the body. They’re lab-made versions of cortisol, a hormone that the body produces naturally to handle stress and control inflammation. Inflammation is part of the immune system’s normal response to injury or illness, but when it lasts too long, it can cause swelling and organ damage.
Steroids help suppress this overactive immune response and are used to treat many health conditions, especially autoimmune diseases, says Jennifer Gershman, PharmD, a pharmacist based in Florida. IgAN is believed to be an autoimmune disease.
Benefits of Steroids for IgAN
In IgAN, the immune system makes poorly formed immunoglobulin A (IgA) antibodies, which are proteins that help the body fight infections. These antibodies travel through the bloodstream and become trapped in the kidneys, triggering inflammation, which damages the glomeruli, the tiny filters that clean the blood. When the glomeruli are damaged, protein can leak into the urine, a sign that the kidneys are not working as they should.
Steroids help lower the immune response, which reduces kidney inflammation and protein loss, says Lakshmi Kannan, MD, a board-certified nephrologist with Sentara Health based in Charlottesville, Virginia. The main goal of using steroids in IgAN is to decrease proteinuria and slow the progression of chronic kidney disease, she says.
Systemic vs. Targeted-Release Steroids
While all steroids help reduce inflammation, they move through the body in different ways. Your nephrologist (kidney doctor) will help you choose the type that best fits your treatment plan:
- Systemic Steroids These are traditional steroids, like prednisone or methylprednisolone, that circulate in the bloodstream and work throughout the entire body. They’re generally effective but tend to impact different organs, which can lead to widespread short-term and long-term side effects.
- Targeted-Release Steroids This newer option, targeted-release budesonide (Tarpeyo), is designed to act more locally. It releases budesonide, a steroid, directly into the gut to lower inflammation and reduce the amount of abnormal IgA antibodies that travel to the kidneys. Because less of the medication enters the bloodstream, it typically causes fewer whole-body side effects.
When Are Steroids Recommended?
Healthcare providers don’t usually recommend steroids right away for IgAN. Most people begin with supportive care, which focuses on protecting the kidneys and controlling blood pressure with medications like angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). High blood pressure can put extra stress on the kidneys and worsen damage.
Lifestyle changes like maintaining a healthy weight, limiting sodium, staying physically active, and quitting smoking are also part of this initial care. Supportive care may include a class of medications called sodium-glucose cotransporter 2 inhibitors, which help protect the kidneys and reduce proteinuria, says Dr. Kannan.
If proteinuria remains high after at least three months of these treatments, steroids may be considered, says Pranav Garimella, MBBS, a nephrologist in San Diego and the chief medical officer at the American Kidney Fund.
According to Kannan and Dr. Garimella, steroids are generally recommended in these circumstances:
- You have persistent proteinuria of 1 gram per day or more.
- You’re already taking the highest dose of an ACE inhibitor or ARB that you can tolerate.
- Your blood pressure is well controlled.
- Your estimated glomerular filtration rate, a measure of how well your kidneys are filtering waste from your blood, is generally above 30.
- A kidney biopsy shows active inflammation, or kidney function is worsening quickly.
It’s worth noting that guidelines now recommend targeted-release budesonide as the first steroid option for IgAN, says Garimella. This helps manage the disease while lowering the risk of widespread side effects. Systemic steroids are typically used when targeted therapy is not suitable, available, or effective, he says.
Common Side Effects and Long-Term Risks
Because steroids mimic cortisol, they affect many organs throughout the body, leading to both short-term and long-term side effects. These side effects vary from person to person and often depend on the dose, the type of steroid, and how long you take it.
For IgAN, steroid treatment may last around six months for prednisone or methylprednisolone, or around nine months for targeted-release budesonide, says Kannan.
Short-Term Side Effects
Short-term steroid use usually means taking the medication for less than 30 days, says Dr. Gershman. Side effects can appear quickly, within days of starting treatment, sometimes after just a few doses of the medication, she says. Common short-term side effects of systemic steroids include the following:
- Weight gain
- Upset stomach
- Insomnia
- Swelling in the legs and midsection
- High blood pressure
- Mood changes, such as irritability or anxiety
- High blood sugar levels
Long-Term Side Effects
Taking steroids for several months or longer increases the risk of additional and more serious side effects. These effects develop gradually and are more likely with higher doses or repeated treatment. Possible long-term side effects include the following:
- Osteoporosis (bone thinning)
- Diabetes or worsening blood sugar control
- Suppression of the adrenal glands, meaning your body may stop producing cortisol
- Weakened immune system and higher infection risk
- Cushing’s syndrome (a condition that causes symptoms such as fat deposits in the face, known as “moon face,” and purple or pink stretch marks on the belly, breasts, and hips)
- Skin thinning
- Easy bruising
- Eye problems, including glaucoma and cataracts
Keep your care team updated on any side effects you notice. Above all, never stop taking steroids suddenly. Suddenly stopping steroids can cause withdrawal symptoms like severe fatigue and weakness. It can also cause a potentially life-threatening condition called adrenal insufficiency, in which your adrenal glands decrease cortisol production. Your healthcare provider will help you gradually lower your dose to give your body time to adjust before stopping it.
Tips for Managing Side Effects
Both Kannan and Gershman suggest a few changes to help manage the side effects of systemic steroids. These include taking steroids in the morning to reduce insomnia and taking them with food to prevent upset stomach.
“It’s also a good idea to check your blood pressure and blood sugar at home while taking steroids, since they can become elevated,” says Gershman. This is especially important if you already have diabetes or prediabetes. You can monitor your blood pressure with a home blood pressure cuff and check your blood sugar with a glucose meter at home. Both are available over the counter at most pharmacies.
Kannan recommends sticking to a low-sodium diet to help reduce fluid retention and swelling. For your bone health, she suggests doing weight-bearing exercises and keeping up with your calcium and vitamin D intake, if your care team recommends these supplements.
Your healthcare provider may adjust your dose or treatment plan if side effects become difficult to manage.
When to Call Your Healthcare Team
Stay in close contact with your care team during steroid treatment. Kannan recommends notifying your healthcare provider if you notice any of the following:
- Signs of an infection, such as a fever or a persistent cough
- Severe mood changes or feelings of depression
- Uncontrolled or very high blood sugar levels
- Severe stomach pain
- Black, tarry stools
- Rapid swelling
- Shortness of breath
- Changes in your vision or severe muscle weakness
The Takeaway
- Steroids may be added to IgA nephropathy treatment to reduce kidney inflammation and help slow disease progression when supportive care alone doesn’t lower proteinuria enough.
- These medications can cause significant side effects, but many of these can be managed with monitoring, lifestyle changes, and medication adjustments.
- A type of steroid called targeted-release budesonide may be an option for some people because it works more locally and may cause fewer widespread side effects. Talk with your nephrology team about what’s right for you.
- Stay in close contact with your healthcare team during treatment with steroids, notify them right away of any new or worsening symptoms, and never stop taking steroids suddenly without medical guidance.
FAQ
How long will I need to be on steroids?
It often depends on the type of steroid, the dose, and the condition being treated. For IgAN, if you’re taking oral prednisone or methylprednisolone, treatment may last around six months, while targeted-release budesonide is usually taken for nine months. Your care team will determine the right length of treatment for you.
Will the side effects go away once I stop the medication?
In most cases, side effects improve after you stop taking steroids. How quickly they go away depends on the dose you were taking and how long you were on treatment. Bone loss may not fully reverse on its own, and some people need additional treatment to protect their bones and prevent fractures.
Can I get vaccines while taking steroids?
It depends on the type of vaccine. Inactivated (non-live) vaccines, such as for influenza (flu) and tetanus, diphtheria, and pertussis (Tdap), are generally safe to receive while taking steroids. Live vaccines — including for measles, mumps, rubella (MMR), and chickenpox, as well as the nasal spray flu vaccine (FluMist) — contain a weakened form of a virus. Because steroids can weaken the immune system, talk with your healthcare team before getting a live vaccine to make sure the timing is safe for you.
Resources We Trust
- Cleveland Clinic: Your Guide to Medications for IgA Nephropathy and C3G
- Mayo Clinic: Prednisone and Other Corticosteroids
- IgA Nephropathy Foundation: Understanding Your Treatment Options
- American Kidney Fund: Prednisone
- National Kidney Foundation: IgA Nephropathy (IgAN)
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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- Corticosteroids (Glucocorticoids). Cleveland Clinic. October 21, 2024.
- Chronic Inflammation: What It Is, Why It’s Bad, and How You Can Reduce It. Mayo Clinic. January 3, 2024.
- Steroids. MedlinePlus. May 29, 2025.
- Lv J et al. Effect of Oral Methylprednisolone on Decline in Kidney Function or Kidney Failure in Patients With IgA Nephropathy: The TESTING Randomized Clinical. JAMA. May 17, 2022.
- Prednisone and Other Corticosteroids. Mayo Clinic. January 21, 2026.
- FDA Approves First Drug to Decrease Urine Protein in IgA Nephropathy, a Rare Kidney Disease. U.S. Food and Drug Administration. December 17, 2021.
- Maixnerova D et al. Expanding Options of Supportive Care in IgA Nephropathy. Clinical Kidney Journal. December 2023.
- Stamellou E et al. The 2025 KDIGO IgA Nephropathy Guideline Update: An ERA Immunonephrology Working Group Perspective. Clinical Kidney Journal. October 22, 2025.
- Kidney Disease: Improving Global Outcomes (KDIGO) IgAN and IgAV Work Group et al. Clinical Practice Guideline for the Management of Immunoglobulin A Nephropathy (IgAN) and Immunoglobulin A Vasculitis (IgAV). Kidney International. October 2025.
- Locatelli F et al. Systemic and Targeted Steroids for the Treatment of IgA Nephropathy. Clinical Kidney Journal. December 4, 2023.
- Tarpeyo Budesonide Capsule, Delayed Release. Dailymed. January 21, 2026.
- Prednisone tablet. Dailymed. July 30, 2024.
- Prednisone Withdrawal: Why Taper Down Slowly? Mayo Clinic. July 2, 2024.
- Prednisone Side Effects and How To Feel Better When Taking Steroids. Cleveland Clinic. December 17, 2024.
- Altered Immunocompetence. Centers for Disease Control and Prevention. June 26, 2024.
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