What Is Glomerulonephritis?

The kidneys are made up of millions of nephrons that allow for the removal of extra fluid and waste out of the blood. All these nephrons consist of tiny filters called glomeruli, which remove toxins and fluid from the blood, and tubules that process the removed fluid and turn it into urine.

Glomerulonephritis (pronounced gluh-mare-you-low-nih-fry-tis), also called glomerular disease, is a group of kidney diseases in which the glomeruli of the kidney become damaged and inflamed. Glomerulonephritis makes it hard for the kidneys to work as they should. This commonly results in the loss of protein out of the blood, and both red and white blood cells in addition to protein may leak into the urine. Some people with glomerulonephritis will lose their ability to filter waste and many will retain fluid. Eventually, some people with glomerulonephritis may develop chronic kidney disease (CKD) or end stage renal disease (ESRD) and have to begin a renal replacement therapy such as dialysis.

Causes of glomerulonephritis

Glomerulonephritis can be acute or chronic. Acute glomerulonephritis can come about because of an infection such as strep throat, chickenpox or malaria. In an acute case of glomerulonephritis, the antibodies that are created to get rid of the body’s infection begin to attack the glomeruli.

With chronic glomerulonephritis, doctors sometimes cannot pinpoint the specific cause. Other times, chronic glomerulonephritis can be the product of a genetic disorder or an autoimmune disease such as lupus in which the body’s immune system attacks various systems in the body. In addition to lupus, other disorders that can cause glomerulonephritis include:

• Focal segmental glomerulosclerosis
  Scar tissue forms in the filtering units of the kidneys or glomeruli, making it hard for the kidneys to function like they should.
• Diabetes
  A disease that affects your body’s ability to produce or use insulin and the most common cause of kidney failure.
• Goodpasture’s syndrome
  An autoimmune disorder that affects the kidneys and lungs, often leading to kidney failure and lung disease.
• IgA nephropathy (Berger’s disease)
  A kidney disease caused by inflammation of the glomeruli that causes blood in the urine.
• Membranoproliferative GN I (MPGN I)
  A kidney disorder marked by inflammation and changes in the structure of the kidney cells.
• Membranoproliferative GN II(MPGN II or dense deposit)
  A disease marked by deposits that build up in the kidneys and scar them so they are unable to function properly.
• Post-streptococcal GN
  A kidney disorder that happens after someone is infected with certain kinds of streptococcus bacteria, the bacteria that cause strep throat or skin infections.

Symptoms of glomerulonephritis

Chronic glomuerulonephritis often causes mild symptoms that may not even be noticed for a while. However, as the disease progresses and causes the kidneys to fail, symptoms may grow worse.

Symptoms include:

• Swollen feet and legs
• Puffy face and eyes
• Decrease in urine production
• Bubbly, cloudy or bloody urine
• Nausea
• Shortness of breath
• Weakness
• Fatigue
• Fever
• Hypertension
• Loss of appetite
• Abdominal pain
• Headaches
• Visual disturbances
• Seizures

Diagnosing glomerulonephritis

There are various ways to diagnose glomerulonephritis:

• During a routine check-up or exam
• Testing that links to specific symptoms
• Blood or urine test
• Image scan of the kidneys
• Kidney biopsy

Treating glomerulonephritis

If glomerulonephritis is mild enough, treatment isn’t necessary and a doctor may simply monitor the situation. Severe, acute glomerulonephritis caused by an infection of some kind may be treated with diet changes and a combination of medicines, including antibiotics to treat the infection, blood pressure medicines and immunosuppressant drugs.

Chronic glomerulonephritis is also treated with immunosuppressant drugs given intravenously or by mouth if the condition is caused by an autoimmune disease. Medicine may also be given to remove antibodies from the blood that could be attacking the kidneys. High blood pressure medicines may also be taken to help slow the progression of glomerulonephritis. Doctors may recommend reducing sodium, potassium and protein in a person’s diet.

Recovery from glomerulonephritis has to do with the cause of the disease, the person’s age and any other health conditions he or she may have. A kidney transplant may be a viable treatment option for someone with glomerulonephritis whose kidneys have failed, but the disease could return in a transplanted kidney. Dialysis is another option for someone with failed kidneys.