Glomerulonephritis

What is glomerulonephritis?

When the kidneys' filters (glomeruli) become inflamed and scarred, it is called glomerulonephritis. The kidneys slowly lose their ability to remove wastes and excess fluid from the blood to make urine.

What causes glomerulonephritis?

Glomerulonephritis can be caused by:

• Toxins or medicines

• Viral infections, such as HIV, hepatitis B, and hepatitis C

• IgA nephropathy or Berger disease

• Lupus-related kidney inflammation

• Bacterial infections that commonly cause throat and skin infections, such as strep or staph bacteria

What are the symptoms of glomerulonephritis?

The kidneys can be badly damaged before any symptoms appear. These are the most common symptoms:

• Fatigue

• High blood pressure

• Swelling of the face, hands, feet, and belly

• Blood and protein in the urine (hematuria and proteinuria)

• Decreased urine output

• Nausea and vomiting

• Fever

• Flu-like symptoms

These symptoms may look like other health problems. Always talk with your healthcare provider for a diagnosis.

How is glomerulonephritis diagnosed?

Your healthcare provider will review your medical history and do a physical exam. You may need other tests, such as:

• Urinalysis. This test checks urine for red and white blood cells, infection, or too much protein.

• Blood tests. These tests measure the levels of waste products to find out how well the kidneys are filtering.

• Ultrasound of the kidney. This test uses high-frequency sound waves and a computer to make images of blood vessels, tissues, and organs. It’s done to see whether the shape or size of the kidney is abnormal. Ultrasounds are used to view organs as they work, and to check blood flow through blood vessels.

• Kidney biopsy. In this test, tissue samples are removed from the kidney and looked at under a microscope.

What is the treatment for glomerulonephritis?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is and the underlying cause of the condition. Some cases of glomerulonephritis get better on their own.

If the illness continues, you may have kidney failure. This has no cure. Treatments focus on slowing the progression of the disease and preventing complications. Treatment may include:

• Blood pressure medicines such as ACE (angiotensin-converting enzyme) inhibitors that protect blood flow into the kidneys

• Corticosteroids to decrease inflammation that leads to scar tissue

• Diuretics (water pills) to remove excess fluid in the body through more urine production

• Diet changes including eating less protein, sodium, and potassium

• Dialysis to remove wastes and fluid from the blood after the kidneys have stopped working

• Kidney transplant to replace your diseased kidney with a healthy kidney from a donor

What are possible complications of glomerulonephritis?

Even with correct treatment, complications may develop. Your kidney function may decrease to the point of kidney failure. If this happens, you may need dialysis or a kidney transplant.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about glomerulonephritis

• Glomerulonephritis is inflammation and damage to the filtering part of the kidneys (glomeruli). It can come on quickly or over a longer period of time. Toxins, metabolic wastes, and excess fluid are not correctly filtered into the urine. Instead, they build up in the body, causing swelling and fatigue.

• The condition can progress to the point that dialysis is needed to clean the blood and remove excess fluid and toxins.

• A kidney transplant may be needed if end-stage renal disease (ESRD) or kidney failure develops.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions.