The kidneys contain filtering units called glomeruli. Each glomerulus filters the blood, removing any waste products and excess fluids.
Glomerulonephritis is the inflammation of the glomeruli. If the glomeruli are damaged, they cannot filter the blood effectively. If not treated properly, glomerulonephritis may lead to serious kidney problems such as end-stage kidney disease (ESKD) or kidney failure.
Key Points
- Glomerulonephritis is a disease in which inflammation damages the glomeruli in the kidneys. This disease can occur quickly (acute) or over time (chronic).
- Excess waste products and fluids are not properly filtered out of the blood, building up in the body and causing swelling and fatigue.
- Glomerulonephritis may continue to progress, leading to ESKD or kidney failure, where dialysis or a kidney transplant is needed.
What is Glomerulonephritis?
Glomerulonephritis is a type of kidney disease caused by damage to the glomeruli caused by excessive immune system stimulation. Each kidney contains one million tiny filters called nephrons, which contain the glomerulus (a filter) and a tubule. The glomerulus is responsible for filtering out waste and excess fluid from the blood.
There are two types of glomerulonephritis: acute and chronic. Acute glomerulonephritis develops suddenly, such as from a viral infection, while chronic glomerulonephritis often develops over time without symptoms. If glomerulonephritis continues, the kidneys can stop working completely, leading to kidney failure.
What Causes Glomerulonephritis?
The causes of glomerulonephritis depend on if it is acute or chronic.
Acute Glomerulonephritis
Acute glomerulonephritis typically occurs in response to an infection, such as strep throat, or due to an immunologic disease where your immune system injuries your own kidneys. Sometimes acute glomerulonephritis happens so quickly that it is referred to as rapidly progressive glomerulonephritis where there can be a very quick decline in kidney function. Early diagnosis and timely treatment are essential to prevent kidney failure in acute glomerulonephritis.
Certain illnesses can trigger acute glomerulonephritis, such as:
- Goodpasture syndrome (a rare autoimmune disease that affects the lungs and kidneys)
- Systemic lupus erythematosus (a chronic autoimmune disease)
- Polyarteritis nodosa (an inflammatory blood vessel disease)
- Wegener’s disease or Granulomatosis with polyangiitis (a rare disease that causes inflammation of the blood vessels)
Chronic Glomerulonephritis
The chronic form of glomerulonephritis may take time to develop and often does not show symptoms. Chronic glomerulonephritis may not always have a clear cause. Possible causes may include:
- Hereditary nephritis
- Genetics
- Immune diseases
- A history of cancer
- Exposure to toxins
In some cases, people may have a single acute attack of glomerulonephritis and develop the chronic form later in life.
Symptoms of Glomerulonephritis
The early symptoms of acute glomerulonephritis include:
- Urinating less than usual
- Hematuria (blood in the urine)
- Puffiness in the face in the morning
- Extra fluid in the lungs
- Hypertension (high blood pressure)
Typically, chronic glomerulonephritis does not present with any symptoms that are unique to the condition. Early signs and symptoms may include:
- Anemia (not enough red blood cells in the blood)
- Hypertension (high blood pressure)
- Hematuria (blood in the urine)
- Proteinuria (too much protein in the urine)
- Edema, swelling in the feet, ankles, legs, face, eyes, or belly
- Extra fluid in the lungs
- Tiredness or general ill feeling
- Excessive urination
- Foamy or bubbly urine
If glomerulonephritis continues to progress, it may lead to serious kidney conditions such as:
- Kidney failure
- Acute kidney injury
- Chronic kidney disease (CKD)
- High potassium (hyperkalemia)
- Nephrotic syndrome (a similar condition to glomerulonephritis)
- Fluid build-up
- Kidney infection
How is Glomerulonephritis Diagnosed?
To see if you have glomerulonephritis, a healthcare provider will look at your medical history and do a physical exam. Other tests may be ordered, such as:
- Blood tests. These tests determine how well the kidneys are working by measuring the levels of waste products in the blood.
- Urinalysis. This test checks the urine for white and red blood cells, for any signs of infection, and if there is too much protein.
- Kidney biopsy. A small piece of the kidney is removed with a special needle to be examined under a microscope. This biopsy is normally always required to determine if you have glomerulonephritis.
- Imaging tests. Imaging tests, such as an ultrasound, X-ray, or CT scan, provide a picture to see if the size or shape of the kidney is abnormal. Ultrasounds provide a view of the organs working, allowing healthcare providers to check blood flow through blood vessels.
How is Glomerulonephritis Treated?
Treatment for glomerulonephritis depends on its cause. A treatment plan will be determined based on your age, medical history and overall health, the level of kidney damage, and the expected duration of your type of glomerulonephritis. Unfortunately, once the glomerulonephritis leads to scaring of the kidneys, the kidneys have been damaged and cannot be cured. Therefore, treatment is an urgent medical situation that should not be delayed.
The goal of treatment is to slow disease progression and prevent any complications from occurring. Treatment options include:
- Blood pressure medications such as angiotensin-converting enzyme (ACE) inhibitors preserve the blood flow into the kidneys.
- Diuretics (water pills) to remove excess fluid in the body by stimulating more urine production.
- Corticosteroids to decrease the inflammation in the kidneys that can lead to scar tissue.
- Dialysis to remove waste products and excess fluids from the blood in late-stage kidney disease and kidney failure.
- A kidney transplant to replace the failed kidney with a healthy kidney from a living or deceased donor.
- Lifestyle changes, including quitting smoking, reducing alcohol consumption, and changing diets to consume less sodium, potassium, and protein.
Are there any Complications Associated with Glomerulonephritis?
Even with early diagnosis and proper treatment, complications of glomerulonephritis may develop. If kidney function continues to decrease, kidney failure can result. If this happens, dialysis or a kidney transplant may be needed.
Other complications associated with glomerulonephritis include:
- High blood pressure
- Nephrotic syndrome
- Chronic kidney failure
- Rapidly progressive glomerulonephritis (quick decline in kidney function)
- Pulmonary edema (caused by too much fluid in the lungs)
- Pulmonary Hemorrage (bleeding into the lungs)
- Hypoalbuminemia (albumin levels in the blood are too low)
- Generalized anasarca (swelling throughout the body)
Can Glomerulonephritis be Prevented?
Glomerulonephritis is not preventable. However, there are steps you can take to lower the chance of developing glomerulonephritis:
- Only taking the recommended does of over-the-counter pain medicines.
- Getting treatment for any active infections.
- Getting medical treatment if you abuse drugs such as heroin or cocaine.
- Seeing your GP or healthcare provider if you think you have strep throat.
- Practicing safe sex to prevent contracting sexually transmitted infections (STIs).
If you have been diagnosed with chronic glomerulonephritis, it is important to controlblood pressure as this may help slow kidney damage.
Panoramic Health
Panoramic Health is kidney care’s leading integrated provider group.. Our mission is to improve patients’ outcomes by slowing disease progression and improving their quality of life. We do this through the distinctive capabilities of our comprehensive care model, which brings together an integrated provider group with operational support, clinical support, and data & analytics at scale.
Through partnerships with practices, providers, payers, and health systems, we work to advance the usage of clinically validated best practices and cutting-edge data analytics across a continuum of reimbursement models.
*The content presented in this article is for informational use only and should not be construed as medical advice or replace the medical advice of a qualified physician.
