Glomerulonephritis

Glomerulonephritis is one of the kidney diseases. It is also called as a glomerular disease, nephritis, or nephrotic syndrome. It is the inflammation of the glomeruli (tiny filters of the kidney). Glomeruli are the clusters of the microscopic blood vessels of the kidneys with tiny pores, through which blood is filtered. The glomeruli help in filtering and removing excess fluids through urine. It is a serious illness of the kidneys, which requires immediate treatment. Prolonged glomerulonephritis can be a life-threatening condition.

It is of two types depending on the development of the condition, acute and chronic. Acute glomerulonephritis is the sudden inflammation of the glomeruli whereas chronic glomerulonephritis is the gradual inflammation of the glomeruli. It is called as primary glomerulonephritis if it occurs on its own. It is called as secondary glomerulonephritis when it occurs due to diseases such as diabetes or lupus. If the nephritis occurs due to systemic lupus erythematous (SLE), then the condition is termed as lupus nephritis.

Signs and Symptoms

The signs and symptoms of nephritis vary for acute or chronic condition.

Acute glomerulonephritis

  • Fluid retention in the face (edema)
  • High blood pressure
  • Infrequent urination
  • Blood in your urine (dark, rust-colored urine)
  • Excessive fluid in lungs, causing coughing

Chronic glomerulonephritis

  • Blood or excessive protein in urine
  • Abdominal pain
  • High blood pressure
  • Frequent bleeding from nose
  • Swelling in ankles and face (edema)
  • Frequent night-time urination
  • Bubbly or foamy urine

Prevention

Follow some measures to prevent nephritis:

  • Seeking immediate treatment in case of strep infections
  • Controlling high blood pressure
  • Controlling intake of high salt and potassium
  • Controlling blood sugar levels
  • Avoiding treatments that lead to infections

Causes

It can be caused by infections such as strep throat, bacterial endocarditis, and viral infections (HIV, hepatitis B and C). Some immune diseases such as lupus, Goodpasture’s syndrome IgA nephropathy and vasculitis such as polyarteritis nodosa, Wegener’s disease may also lead to glomerulonephritis. Sometimes it can also be hereditary and can lead to chronic glomerulonephritis. Alport is an inherited form of glomerulonephritis which can lead to hearing and vision impairment. An acute attack can develop into a chronic attack if it is untreated. Kidney failure is the first indication of a chronic glomerulonephritis. Some conditions such as high blood pressure, diabetic kidney disease, and focal segmental glomerulosclerosis can lead to scarring of the glomeruli.

To assess the kidney function and diagnose glomerulonephritis, following diagnostic tests are suggested by the doctor:

Blood tests: Blood tests are recommended to identify anemia, blood urea nitrogen levels, creatinine levels, and albumin levels. These tests help in identifying abnormalities.
Urine tests: Urine tests are recommended to check total protein in the urine, concentration of the urine, percentage of white blood cells and red blood cells, specific gravity of urine, osmolality of urine, and creatinine clearance levels. These tests help in identifying the damage levels of the glomeruli.
Imaging tests: Imaging tests are suggested to visualize and identify the damage of the kidney. The imaging tests such as kidney X-ray, ultrasound, and CT scan are used in the diagnosis.
Immunology tests: The immune system health is assessed by checking for antineutrophil cytoplasmic antibodies, antiglomerular basement membrane antibodies, and antinuclear antibodies.
Kidney biopsy: It is performed by using a special needle to extract some tissues of the kidney to determine the cause of inflammation.

The treatment of nephritis depends on the condition (acute or chronic), the severity of the symptoms, and the underlying cause. Glomerulonephritis due to strep infection can resolve on its own, and no treatment is required. The glomerulonephritis treatment involves protection of the kidneys from further damage.

To control high blood pressure levels, your doctor may prescribe angiotensin-converting enzyme (ACE) inhibitors, diuretics, and angiotensin II receptor blockers. Antibiotics are suggested by the doctors to control the underlying infections. Corticosteroids and immune suppressing drugs are suggested to control the inflammation. Plasmapheresis is suggested if the underlying cause is Goodpasture’s syndrome. In some acute conditions and kidney failure, dialysis is suggested. A kidney transplantation is also necessary in the case of end-stage of kidney disease.