GLOMERULONEFRITIS

What Is It?
Glomerulonephritis is a disease of the kidneys in which there is inflammation of the filtering
units, called glomeruli. This inflammation can cause protein and red blood cells to leak into the
urine while toxins normally removed by the kidney are retained in the body. Kidney failure
develops when the kidney becomes less effective at filtering out waste products, water and salt
from the blood.
There are many types and causes of glomerulonephritis. These include:

Prior infection: For example, after a streptococcal infection (such as strep throat),
kidney failure may develop with associated problems of high blood pressure, dark urine,
and swelling in the legs. Glomerulonephritis following streptococcal bacterial infection is
among the most common types of post-infectious disease, especially among children.

Autoimmune: With conditions such as systemic lupus erythematosus (SLE) or blood

vessel inflammation (vasculitis), the body's immune system mistakenly attacks healthy
tissue. When the kidney's filtering system is the target, glomerulonephritis may develop.

Antibody-mediated: The most common type is called IgA nephropathy. While this can
be associated with liver disease, celiac disease or HIV infection, many cases are of
unknown cause. Immunoglobulin A, an antibody that normally helps fight off infection,
is deposited in the kidney, leading to hematuria (blood in the urine) but less commonly
more serious problems.

Membranous glomerulonephritis: This condition may develop as part of lupus or on its

own. The hallmark of this type of kidney disease is the leakage of protein into the urine.

Rapidly progressive glomerulonephritis: This condition may be diagnosed when there

is kidney inflammation and loss of kidney function over weeks to months. Triggers
include infections, autoimmune disease, and certain types of antibody-mediated kidney
disease.

Idiopathic: When glomerulonephritis develops for no apparent reason it is called

"idiopathic." It's possible that an undetected or undiagnosed infection or a hereditary
cause led to kidney inflammation and damage.

Symptoms
If glomerulonephritis is mild, it may not cause any symptoms. In that case, the disease may be
discovered only if protein or blood is found in the urine during a routine test. In other people, the

first clue can be the development of high blood pressure. If symptoms appear, they can include
swelling around the feet, ankles, lower legs, and eyes, reduced urination and dark urine (due to
the presence of red blood cells in the urine).
High levels of protein in the urine can cause the urine to appear foamy. If severely elevated blood
pressure develops, some people will have headaches (although most people with high blood
pressure have no symptoms and most headaches are unrelated to blood pressure). Fatigue, nausea
and tremulousness are other common symptoms of kidney failure due to glomerulonephritis. In
severe cases, confusion or coma may develop.

Diagnosis
Your doctor will ask you about symptoms of a prior infection, family history, or symptoms of
conditions that can affect the kidneys. For example, joint pain and rash are the most common
symptoms of lupus. Your doctor will ask how often you are urinating, how much urine you are
producing and the color of the urine. To check for a history of swelling, your doctor may ask
whether you've noticed puffiness around your eyes, unusual tightness in your shoes or waistband
or a feeling of heaviness in your legs or ankles.
During your physical examination, your doctor will measure your blood pressure, weigh you to
check for weight gain resulting from water retention, and check for swelling in your legs or
elsewhere. A complete physical examination is important to look for evidence of other organ
involvement such as arthritis or rash.
To confirm the diagnosis of glomerulonephritis, your doctor will evaluate your kidney function
through blood tests and an analysis of the urine (called a urinalysis) that detects blood, protein or
signs of infection. You also may need specialized blood testing to check for specific autoimmune
disease. A kidney biopsy, in which a tiny piece of kidney tissue is removed and examined in a
laboratory, is the most helpful test when glomerulonephritis is suspected.

Expected Duration
How long glomerulonephritis lasts depends on its cause and on the severity of kidney damage.
When glomerulonephritis follows an infection, the problem usually goes away within weeks to
months. In other cases, glomerulonephritis becomes a chronic (long-lasting) condition that lasts
for years and eventually can lead to kidney failure.

Prevention
To prevent glomerulonephritis following an infection, the infection must be treated promptly.
Most forms of glomerulonephritis cannot be prevented. Once kidney disease, such as
glomerulonephritis is present, avoiding certain medications (such as ibuprofen, naproxen or other
anti-inflammatory drugs) can prevent sudden worsening. Complications of kidney disease, such

as anemia and bone problems, may be prevented or minimized by appropriate monitoring and
timely medical treatment.

Treatment
When glomerulonephritis is caused by an infection, the first step in treatment is to eliminate the
infection. If bacteria caused the infection, antibiotics may be given. However, children who
develop the disease following a streptococcal infection often recover without any specific
treatment.
When glomerulonephritis has slowed the amount of urine a person is producing, he or she may
be given medications called diuretics, which help the body to rid itself of excess water and salt
by producing more urine. More severe forms of the disease are treated with medications to
control high blood pressure, as well as changes in diet to reduce the work of the kidneys. Some
people with severe glomerulonephritis may be treated with medications called
immunosuppressive drugs, which decrease the activity of the immune system. Such medications
include azathioprine (Imuran), corticosteroids (Prednisone, Methylprednisolone),
cyclophosphamide (Cytoxan), rituximab (Rituxan) or mycophenolate mofetil (CellCept). Plasma
exchange, a procedure during which substances thought to cause inflammation and kidney
damage are removed from the blood, can be helpful in certain types of autoimmune or antibodymediated glomerulonephritis. When glomerulonephritis progresses to severe, irreversible renal
failure, treatment options include dialysis or a kidney transplant.

When To Call A Professional

Call your doctor if you or your child is putting out less urine then normal or if urine looks bloody
or abnormally dark. Also call your doctor if you notice unusual swelling, particularly around the
eyes or in the legs or feet. If you have a history of a kidney problem and you develop any of
these symptoms, you should seek medical assistance without delay.

Prognosis
Children with glomerulonephritis usually recover completely if their illness is mild or if it
develops following a strep infection. Although adults often have a poorer outlook, some recover
completely. More severe forms of the disease may eventually lead to kidney failure, which may
ultimately require lifelong treatment with dialysis or a kidney transplant.

http://www.drugs.com/health-guide/glomerulonephritis.html

Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter
waste and fluids from the blood is damaged.

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Back to TopAlternative Names

Glomerulonephritis - chronic; Chronic nephritis; Glomerular disease; Necrotizing

glomerulonephritis; Glomerulonephritis - crescentic; Crescentic glomerulonephritis; Rapidly
progressive glomerulonephritis
Back to TopCauses

Glomerulonephritis may be caused by problems with the body's immune system. Often, the exact
cause of glomerulonephritis is unknown.
Damage to the glomeruli causes blood and protein to be lost in the urine.
The condition may develop quickly, and kidney function is lost within weeks or months (called
rapidly progressive glomerulonephritis).
A quarter of people with chronic glomerulonephritis have no history of kidney disease.
The following may increase your risk of this condition:

Blood or lymphatic system disorders

Exposure to hydrocarbon solvents

History of cancer

Infections such as strep infections, viruses, heart infections, or abscesses

Many conditions cause or increase the risk for glomerulonephritis, including:

Amyloidosis

Anti-glomerular basement membrane antibody disease

Blood vessel diseases, such as vasculitis or polyarteritis

Focal segmental glomerulosclerosis

Goodpasture syndrome

Heavy use of pain relievers, especially NSAIDs

Henoch-Schonlein purpura

IgA nephropathy

Lupus nephritis

Membranoproliferative GN

Back to TopSymptoms

Common symptoms of glomerulonephritis are:

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

Foamy urine (due to excess protein in the urine)

Swelling (edema) of the face, eyes, ankles, feet, legs, or abdomen

Symptoms may also include the following:

Abdominal pain

Blood in the vomit or stools

Cough and shortness of breath

Diarrhea

Excessive urination

Fever

General ill feeling, fatigue, and loss of appetite

Joint or muscle aches

Nosebleed

The symptoms of chronic kidney disease may develop over time.

Chronic renal failure symptoms may gradually develop.
Back to TopTreatment

Treatment depends on the cause of the disorder, and the type and severity of symptoms. High
blood pressure may be hard to control. Controlling high blood pressure is usually the most
important part of treatment.
Medicines that may be prescribed include:

Blood pressure medications to control high blood pressure, most commonly

angiotensin-converting enzyme inhibitors and angiotensin receptor blockers

Corticosteroids

Medications that suppress the immune system

A procedure called plasmapheresis may sometimes be used for glomerulonephritis caused by

immune problems. The fluid part of the blood that contains antibodies is removed and replaced
with intravenous fluids or donated plasma (that does not contain antibodies). Removing
antibodies may reduce inflammation in the kidney tissues.
You may need to limit salt, fluids, protein, and other substances.
Persons with this condition should be closely watched for signs of kidney failure. Dialysis or a
kidney transplant may eventually be needed.
Back to TopSupport Groups

You can often ease the stress of illness by joining support groups where members share common
experiences and problems.
See: Kidney disease - support group
Back to TopPrevention

There is no way to prevent most cases of glomerulonephritis. Some cases may be prevented by
avoiding or limiting exposure to organic solvents, mercury, and nonsteroidal anti-inflammatory
drugs (NSAIDs).

Back to TopReferences

Appel GB. Glomerular disorders and nephrotic syndromes. In: Goldman L, Ausiello D, eds.
Cecil Medicine . 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 122.
Nachman PH, Jennette JC, Falk RJ. Primary glomerular disease. In: Brenner BM, ed. Brenner
and Rector's The Kidney . 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 30.