Glomerulonephritis

(Glomerular Disease)

Definition

Glomerulonephritis is damage to the glomeruli. Glomeruli are the tiny structures within the kidney that filter blood.

The kidneys are bean-shaped organs located in the back just below the rib cage. Each kidney is about the size of a fist. The 2 kidneys filter blood, catch needed substances and return them to the circulation, and dispose of wastes in the urine. If the kidneys don’t filter properly, wastes build up in the blood.

There are 2 types of glomerulonephritis:

Acute glomerulonephritis begins suddenly.
Chronic glomerulonephritis develops gradually over several years.

In some cases, glomerulonephritis leads to kidney failure. Kidney failure is a severe kidney disease that must be treated with dialysis or kidney transplant.

Anatomy of the Kidney

Causes

Causes of glomerulonephritis include:

Strep throat
Impetigo—skin infection
Genetics
Autoimmune disorders, such as systemic lupus erythematosus
Type 1 and type 2 diabetes
Inflammation of the blood vessels—vasculitis
Viruses, such as HIV, hepatitis B, and hepatitis C
Inflammation of the tissue lining the heart—endocarditis
Drugs and toxins

Risk Factors

Factors that may increase your chance of glomerulonephritis include:

Family history of glomerulonephritis
The presence of a known cause of glomerulonephritis
Exposure to a cause
High blood pressure

Symptoms

Glomerulonephritis sometimes causes no symptoms and is discovered during a routine urine test. When present, the symptoms of acute and chronic glomerulonephritis differ from 1 another.

The symptoms of acute glomerulonephritis may include:

Blood in urine
Foamy appearance of urine
Less frequent urination
Swelling in the morning, especially in the face, feet, hands, and abdomen

Chronic glomerulonephritis can lead to kidney failure. Symptoms may include:

Fatigue
Dry, itchy skin
Nausea and vomiting
Poor appetite
Muscle cramps at night
Swelling of the face, feet, hands, or abdomen

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a nephrologist who specializes in kidney disease for further diagnostic testing and treatment.

Tests may include

Blood tests
Urine tests
Kidney biopsy

Imaging tests may be done to evaluate the kidneys and surrounding structures. This can be done with:

Treatment

Treatment will depend on the cause of glomerulonephritis. The following steps may be taken to help kidney function or reduce further damage:

Medications

Glomerulonephritis can be treated with:

Diuretics to reduce fluid retention
Corticosteroids to suppress the immune system
ACE inhibitors to control blood pressure and protein excretion

Lifestyle Changes

Restrict salt and water intake.
Restrict intake of potassium, phosphorous, and magnesium.
Cut down on protein in the diet.
Maintain a healthy weight through diet and exercise.
Take calcium supplements.

Dialysis and Transplant

If the kidneys are unable to remove sufficient waste from the blood, dialysis may be required. Temporary dialysis may be sufficient for acute glomerulonephritis. If it leads to permanent kidney failure, chronic glomerulonephritis will require long-term dialysis or kidney transplant.

Prevention

To help reduce your chance of glomerulonephritis:

Follow treatment plans for chronic disorders, such as high blood pressure or diabetes.
Seek prompt treatment for a sore throat.
Practice safe sex and avoid drug use to reduce the risk of HIV infection.

RESOURCES

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

National Kidney Foundation
http://www.kidney.org

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca

Kidney Foundation of Canada
http://www.kidney.ca

References

Glomerulonephritis (list of topics). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 26, 2016. Accessed June 1, 2016.

Glomerulonephritis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/glomerul. Accessed June 1, 2016.

Revision Information

Reviewer: Adrienne Carmack, MD
Review Date: 06/2016
Update Date: 05/28/2014

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.