Description

Glomerulonephritis (gloe-MER-u-loe-nuh-FRY-tis) is inflammation of the tiny filters in the kidneys (glomeruli). The excess fluid and waste that glomeruli (gloe-MER-u-lie) to remove from the blood leaves the body in the form of urine. Glomerulonephritis can occur suddenly (acute) or gradually (chronic).

Glomerulonephritis occurs on its own or as part of another disease, such as lupus or diabetes. Severe or prolonged inflammation associated with glomerulonephritis can damage the kidneys. The treatment depends on the type of glomerulonephritis has.

Symptoms

The signs and symptoms of glomerulonephritis may vary depending on if you have acute or chronic, and the cause. You may notice no symptoms of the chronic disease. Your first indication that something is wrong can come from the results of a routine urine test (urinalysis).

Glomerulonephritis signs and symptoms may include:

  • Pink or cola-colored urine from red blood cells in the urine (hematuria).
  • Foam or bubbles in the urine due to excess protein in the urine (proteinuria).
  • High blood pressure (hypertension).
  • Fluid retention (edema) with swelling evident in your face, hands, feet, and abdomen.
  • Urinating less than usual.
  • Nausea and vomiting.
  • Muscle cramps.
  • Fatigue.

When to see a doctor

Make an appointment with your health care provider right away if you have signs or symptoms of glomerulonephritis.

Causes

Many conditions can cause glomerulonephritis. Sometimes the disease runs in families and, sometimes, the cause is unknown. The factors that can lead to inflammation of the glomeruli, which include the following conditions.

Infections

Infectious diseases can directly or indirectly lead to glomerulonephritis. These infections include:

  • Post-streptococcal glomerulonephritis. Glomerulonephritis can develop one or two weeks after recovery from a strep throat infection or, rarely, a skin infection caused by a bacterium strep (impetigo). Inflammation occurs when the antibodies to the accumulation of bacteria in the glomeruli. Children are more likely to develop post-streptococcal glomerulonephritis are adults, and are also more likely to recover quickly.
  • The bacterial endocarditis. Bacterial endocarditis is an infection of the inner lining of your heart's chambers and valves. It is not clear whether inflammation in the kidneys is the result of the activity of the immune system alone or with other factors.
  • Viral infections of kidney. Viral infections of the kidneys, such as hepatitis B and hepatitis C, which causes inflammation of the glomeruli, and other tissues of the kidney.
  • HIV. Infection with HIV , the virus that causes AIDS , can lead to glomerulonephritis, and progressive renal injury, even before the onset of AIDS .

Autoimmune diseases

Autoimmune diseases are diseases caused by the immune system attacking healthy tissues. Autoimmune diseases that can cause glomerulonephritis include:

  • Lupus. A chronic inflammatory disease, systemic lupus erythematosus can affect many parts of your body, including the skin, joints, kidneys, blood cells, heart and lungs.
  • Goodpasture syndrome. In this rare disorder, also known as anti-GBM disease, the immune system creates antibodies against the tissues of the lungs and the kidneys. It can cause progressive and permanent damage to the kidneys.
  • The IgA nephropathy. The immunoglobulin a (IgA) is an antibody that a first line of defense against infectious agents. IgA nephropathy occurs when deposits of antibodies accumulate in the glomeruli. Inflammation and subsequent damage can go unnoticed for a long time. The most common symptom is blood in the urine.

Vasculitis

Vasculitis is the inflammation of the blood vessels. Types of vasculitis that can cause glomerulonephritis include:

  • Polyarteritis. This form of vasculitis that affects small and medium blood vessels in many parts of your body, including the kidneys, the skin, the muscles, joints and the digestive tract.
  • Granulomatosis with polyangiitis. This form of vasculitis, formerly known as Wegener's granulomatosis, affects small and medium blood vessels in the lungs, upper respiratory tract and the kidneys.

Sclerotic conditions

Some of the diseases or conditions cause scarring of the glomeruli, which results in poor and declining renal function. These include:

  • The high blood pressure. Long-term, poorly managed high blood pressure can cause scarring and inflammation of the glomeruli. Glomerulonephritis inhibits the function of the kidney role in the regulation of blood pressure.
  • Diabetic kidney disease (diabetic nephropathy). High blood sugar levels contribute to the scarring of the glomeruli and increase the rate of blood flow through the nephrons.
  • Focal segmental glomerulosclerosis. In this condition, the healing is divided among some of the glomeruli. This may be the result of another disease, or it may occur for no known reason.

Other causes

Infrequently, chronic glomerulonephritis runs in families. A hereditary form, Alport syndrome, may also affect hearing, or vision.

Glomerulonephritis is associated with certain types of cancer, such as gastric cancer, lung cancer, and chronic lymphocytic leukemia.

Risk factors

Some autoimmune diseases are associated with immune-mediated glomerulonephritis.

Complications

Glomerulonephritis affects the ability of the nephrons to filter the bloodstream efficiently. The breakdown of the results of filtering in:

  • The accumulation of waste or toxins in the bloodstream.
  • The lack of regulation of the essential minerals and nutrients.
  • The loss of red blood cells.
  • The loss of protein in the blood.

The possible complications of glomerulonephritis include:

  • The acute renal failure. Acute renal failure is the sudden and rapid decline of renal function, often associated with an infectious cause of glomerulonephritis. The accumulation of waste and fluids can be fatal if not treated quickly with an artificial filtering of the machine (dialysis). The kidneys often resume the typical function after recovery.
  • Chronic kidney disease. The persistence of the inflammation results in the long term, the damage and the decreased function of the kidneys. Chronic kidney disease is generally defined as kidney damage or decreased function for three months or more. Chronic kidney disease can progress to end-stage kidney disease that requires dialysis or a kidney transplant.
  • The high blood pressure. The damage to the glomeruli of the inflammation or scarring can lead to an increase of the blood pressure.
  • The nephrotic syndrome. Nephrotic syndrome is a disease in which there is an excess of protein in the blood, in the urine and too little in the bloodstream. These proteins play a role in the regulation of liquids and levels of cholesterol. A drop in the blood's proteins results in high cholesterol, high blood pressure and swelling (edema) of the face, hands, feet, and abdomen. In rare cases, nephrotic syndrome can cause a blood clot in a blood vessel in the kidney.

Prevention

There may be no way to prevent some forms of glomerulonephritis. However, here are some steps that may be useful:

  • Seek immediate treatment of a strep infection with a sore throat or impetigo.
  • To prevent infections that can lead to some forms of glomerulonephritis, such as HIV and hepatitis, follow safe sex guidelines, and avoid the use of intravenous drugs.
  • Control of high blood pressure, which lessens the likelihood of damage to the kidney from hypertension.
  • The Control of your blood sugar to help prevent diabetic nephropathy.

Diagnosis

Glomerulonephritis can be identified with tests, if you have an acute illness or during routine testing during a wellness visit or an appointment managing a chronic illness, such as diabetes. Tests to assess renal function and to make a diagnosis of glomerulonephritis include:

  • Urine test. A urine analysis may reveal signs of malfunction of the kidneys, such as red blood cells and proteins that should not be in the urine or in the white cells of the blood are a sign of inflammation. There may also be a lack of the expected levels of the waste products.
  • Blood tests. The analysis of blood samples can reveal higher than expected levels of waste products in the blood, the presence of antibodies that may indicate an autoimmune disorder, bacterial or viral infection, or blood sugar level that indicates diabetes.
  • Imaging tests. If your doctor detects evidence of kidney disease, he or she may recommend imaging tests, which may show an irregularity in the shape or the size of the kidneys. These tests can be an x-ray, ultrasound, or ct scan.
  • The renal biopsy. This procedure involves the use of a special needle to remove small pieces of kidney tissue to look at under a microscope. By means of a biopsy to confirm the diagnosis and assess the nature and the degree of tissue damage.

Treatment

The treatment of glomerulonephritis, and your result will depend on:

  • If you have an acute or chronic disease.
  • The underlying cause.
  • The type and severity of the signs and symptoms.

Some cases of acute glomerulonephritis, especially those who follow an infection with streptococcal bacteria, it may improve on its own and requires no treatment. If there is an underlying cause — such as high blood pressure, an infection, or an autoimmune disease — treatment will be directed at the underlying cause.

In general, the goal of treatment is to protect the kidneys from further damage and to preserve renal function.

Therapies for associated renal failure

Renal failure is the loss of 85% or more of the renal function. Acute renal failure due to infection-related glomerulonephritis is treated with dialysis. Dialysis is used for a device that works as an artificial, external, kidney filters the blood.

In the final stage of kidney disease is chronic kidney disease that can only be managed by regular dialysis or a kidney transplant.

Lifestyle and home remedies

If you have kidney disease, your doctor may recommend certain lifestyle changes:

  • Reduce the intake of salt to prevent or minimize fluid retention, swelling, and hypertension.
  • Eat less protein and potassium to slow the buildup of wastes in the blood.
  • Maintain a healthy weight.
  • Take your medicines as directed by your health care provider.
  • Control your blood sugar if you have diabetes.
  • Stop smoking.

Coping and support

Living with a chronic illness can tax your emotional resources. If you have chronic glomerulonephritis or chronic kidney disease, you might benefit from joining a support group. A support group can provide both sympathetic listening and useful information.

To find a support group, ask your doctor for a recommendation or in contact with the National Kidney Foundation to find the chapter nearest to you.

Preparing for your appointment

It is likely to start by seeing your primary care provider. If the laboratory tests reveal that you have kidney damage, you may be referred to a doctor who specializes in problems of the kidneys (nephrologist).

What you can do

To prepare for your appointment, ask if there is something that you need to make ahead of time, such as the limit of what you eat and drink. Then, make a list of items you may need to discuss with your health care provider:

  • Your symptoms, including any that seem unrelated to your kidneys or urinary function, and when they began.
  • Of all their medications and dosages, including vitamins or other supplements that you take.
  • Its key of the medical history, including any other medical condition and medical history of the family.

Have a friend or family member, if possible, to help you remember the information they give you.

When you have follow-up appointments after a diagnosis of glomerulonephritis, you may want to ask the following questions:

  • How good are my functioning of the kidneys? Has the role changed since the previous review?
  • When do I have to do the lab work or other appointments?
  • I'm going to need dialysis?
  • What help can I get to handle-related conditions, such as the compatibility with the planning of the diet or exercise?
  • What should I do if I forget a dose of a prescription drug?
  • When should I call for an appointment or to receive the urgent care?
  • Are there brochures or other printed material I can have? What sites do you recommend?
Symptoms and treatment of Glomerulonephritis