Glomerulonephritis Health Article

Definition

Glomerulonephritis is a type of kidney disease caused by inflammation of the internal kidney structures (glomeruli), which help filter waste and fluids from the blood.

Causes, incidence, and risk factors

Glomerulonephritis may be caused by specific problems with the body's immune system, but the precise cause of some cases is unknown. Damage to the glomeruli causes blood and protein to be lost in the urine.

The condition may develop after survival of the acute phase of rapidly progressive glomerulonephritis. In about a quarter of people with chronic glomerulonephritis there is no prior history of kidney disease and the disorder first appears as chronic renal failure.

Specific disorders that are associated with glomerulonephritis include:

• Focal segmental glomerulosclerosis
• Goodpasture syndrome
• IgA nephropathy
• Lupus nephritis
• Membranoproliferative GN I
• Membranoproliferative GN II
• Post-streptococcal GN
• Rapidly progressive glomerulonephritis

Symptoms

• Blood in the urine (dark, rust-colored, or brown urine)
• Foamy urine

Chronic renal failure symptoms that may gradually develop include the following:

• Unintentional weight loss
• Nausea, vomiting
• General ill feeling (malaise)
• Fatigue
• Headache
• Frequent hiccups
• Generalized itching
• Decreased urine output
• Need to urinate at night
• Easy bruising or bleeding
• Decreased alertness
  • Drowsiness, somnolence, lethargy
  • Confusion, delirium
  • Coma
• Muscle twitching
• Muscle cramps
• Seizures
• Increased skin pigmentation (hyperpigmentation) -- skin may appear yellow or brown
• Decreased sensation in the hands, feet, or other areas

Additional symptoms that may be associated with this disease:

• Excessive urination
• Nosebleed
• High blood pressure
• Blood in the vomit or in stools

Signs and tests

Because symptoms develop gradually, the disorder may be discovered when there is an abnormal urinalysis during routine physical or examination for unrelated disorders.

Glomerulonephritis can cause high blood pressure and may only be discovered as a cause of high blood pressure that is difficult to control.

Laboratory tests may reveal anemia or show signs of reduced kidney functioning, including azotemia (accumulation of nitrogenous wastes such as creatinine and urea).

Later, signs of chronic kidney failure may be seen, including edema (swelling), polyneuropathy, and signs of fluid overload including abnormal heart and lung sounds.

Tests that may be done include:

• Abdominal CT scan
• Abdominal ultrasound
• Chest x-ray
• IVP
• Kidney biopsy
• Urinalysis

This disease may also alter the results of the following tests:

• Albumin
• Anti-glomerular basement membrane
• BUN
• Complement component 3
• Complement
• Creatinine clearance
• Total protein
• Uric acid, urine
• Urine concentration test
• Urine creatinine
• Urine protein
• Urine RBC
• Urine specific gravity

Treatment

Treatment varies depending on the cause of the disorder, and the type and severity of symptoms. High blood pressure may be difficult to control, and it is generally the most important aspect of treatment.

Medicines that may be prescribed include:

• Blood pressure medications
• Corticosteroids
• Immunosuppressives

Dietary restrictions on salt, fluids, protein, and other substances may be recommended.

Dialysis or kidney transplantation may be necessary to control symptoms of kidney failure and to sustain life.

Support Groups

The stress of illness can often be helped by joining support groups where members share common experiences and problems.

See: Kidney disease - support group

Expectations (prognosis)

Glomerulonephritis may be a temporary and reversible condition, or it may get worse. Progressive may result in chronic kidney failure and end stage kidney disease.

If nephrotic syndrome is present and can be controlled, other symptoms may be controlled. If it can't be controlled, end-stage kidney disease may result.