Glomerulonephritis

What is glomerulonephritis?

Glomerulonephritis is a kidney disease in which the glomeruli become inflamed and cannot effectively filter waste out of the bloodstream. The glomeruli are filters in the kidney made up of tiny blood vessels. These filters provide the essential service of filtering the blood by removing waste, electrolytes, and excess fluid from the bloodstream. The filtered waste exits the body by passing through urine.

Acute glomerulonephritis develops suddenly, and chronic glomerulonephritis develops gradually. Glomerulonephritis can occur on its own or with a comorbidity, like diabetes or lupus. Left untreated, glomerulonephritis can cause kidney damage and kidney failure.

What causes glomerulonephritis?

The exact cause of glomerulonephritis depends on whether it is acute or chronic.

A rare form of glomerulonephritis, called Alport syndrome, is genetic. Some cases of chronic glomerulonephritis have no clear cause. However, most cases of glomerulonephritis are a result of other conditions.

See below for a list of specific conditions that cause glomerulonephritis.

Vasculitis

• Granulomatosis with polyangiitis. Previously known as Wegener’s granulomatosis, this type of vasculitis impacts small and medium-sized blood vessels in the kidneys, upper airways, and lungs.
• This type of vasculitis impacts small and medium-sized blood vessels all over the body, including the intestines, kidneys, and heart.

Immune Diseases

• Goodpasture’s syndrome. This immune disease displays similar symptoms to pneumonia. Goodpasture’s syndrome is a rare lung disorder that can cause bleeding in the lungs and glomerulonephritis.
• This disease can cause chronic inflammation in the blood cells, joints, kidneys, skin, heart, and lungs.
• IgA nephropathy. This disease comes from deposits of immunoglobulin A (IgA) in the glomeruli and causes bloody urine.

Infections

• Viral infections. Sometimes, hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) can cause glomerulonephritis.
• Bacterial endocarditis. This bacterial infection is associated with glomerular disease, but scientists do not know the cause of this connection.
• Post-streptococcal glomerulonephritis. A strep throat infection can cause glomerulonephritis about a week or two after strep throat recovery. The body needs extra antibodies to fight an infection, and the glomeruli end up storing those antibodies and becoming inflamed.

What are symptoms of glomerulonephritis?

Symptoms of glomerulonephritis differ based on whether someone has an acute or chronic case, as well as what caused their case of glomerulonephritis.

Acute glomerulonephritis develops quickly. Common acute glomerulonephritis symptoms include:

• High blood pressure
• Brown/pink-colored urine
• Fluid retention in the face
• Coughing due to extra fluid in the lungs
• Less urinating overall

The chronic form of glomerulonephritis may develop slowly. It often starts without any symptoms at all. Chronic glomerulonephritis might present similar symptoms to acute glomerulonephritis at first. Common chronic glomerulonephritis symptoms include:

• Foamy or bubbly urine from excess protein
• High blood pressure
• Abdominal pain
• Fluid retention in the face and ankles
• Frequent nighttime urination
• Frequent nosebleeds

Advanced glomerulonephritis might result in kidney failure. Symptoms of kidney failure include:

• Insomnia
• Loss of appetite
• Nighttime muscle cramps
• Fatigue
• Nausea and vomiting
• Itchy, dry skin

Other potential complications of glomerulonephritis include:

• Chronic kidney disease, which causes a gradual loss of kidney function and other health issues.
• Nephrotic syndrome, a kidney disorder in which the body passes too much protein in the urine.
• Electrolyte imbalances, including high levels of potassium and sodium.
• Pulmonary edema, a condition in which excess fluid in the lungs makes it difficult to breathe.
• High blood pressure, when the force of blood flowing through the blood vessels is too high for prolonged periods of time.
• Congestive heart failure, a heart condition in which the heart cannot pump blood as effectively as it should.
• Chronic urinary tract infections, an infection of the urinary tract that causes extreme discomfort and, if it spreads, potentially serious health consequences.
• Malignant hypertension, in which extremely high blood pressure develops very suddenly and can cause organ damage.
• Increased risk of infection, which can impact areas throughout the body.

Are there any risk factors or groups for glomerulonephritis?

Aside from Alport syndrome, glomerulonephritis is not necessarily a genetic disease. Some groups have a higher risk of developing glomerulonephritis. The following conditions can either cause or increase the risk of glomerulonephritis:

• Membranoproliferative glomerulonephritis
• Henoch-Schönlein purpura
• Anti-glomerular basement membrane disease
• Amyloidosis
• Focal segmental glomerulosclerosis
• Analgesic nephropathy syndrome
• History of cancer, specifically lung cancer, multiple myeloma, and chronic lymphocytic leukemia
• Exposure to hydrocarbon solvents

How is glomerulonephritis diagnosed?

Glomerulonephritis does not always present symptoms. However, several tests can reveal signs of glomerulonephritis. A doctor might schedule one or more of the following tests to figure out if a patient has glomerulonephritis:

• Blood test – This test will reveal the level of creatinine in a blood sample. A blood test also shows whether anemia, abnormal blood urea nitrogen, and abnormal albumin levels are present.
• Urine test – This test will check urine concentration, creatinine clearance, total protein in the urine, urine red blood cells, and urine osmolality to determine if a patient has glomerulonephritis.
• Immunology test – This test checks the patient’s antinuclear antibodies, antiglomerular basement membrane antibodies, antineutrophil cytoplasmic antibodies, and complement levels.
• Ultrasound – This test checks the size of the kidneys and reveals blockages and other potential issues.
• Kidney biopsy – A doctor will remove a small piece of kidney tissue and examine it under a microscope to look for signs of glomerulonephritis.

How is glomerulonephritis treated?

There are several glomerulonephritis treatments. A treatment plan will depend on what type of glomerulonephritis someone has, the cause, and what kind of symptoms the patient has. Treatments for glomerulonephritis include:

Controlling high blood pressure. A doctor might prescribe angiotensin-converting enzyme inhibitors, like lisinopril, captopril, and perindopril. Angiotensin receptor blockers, like irbesartan, losartan, and valsartan, are another potential high blood pressure treatment.

• Reducing immune response. Corticosteroids can relieve some symptoms when the immune system begins attacking the kidneys. A doctor might recommend plasmapheresis, a process which removes plasma and switches it out for intravenous fluids or donated plasma that does not have antibodies.
• Using dialysis to remove excess fluid, clean the blood, and reduce blood pressure.
• Taking diuretics to bring down swelling.

Chronic illnesses, like glomerulonephritis, are emotionally taxing. People living with glomerulonephritis might consider joining a support group. Find a glomerulonephritis support group by speaking with a doctor or contacting the nearest National Kidney Foundation chapter.

What are lifestyle changes that could help with glomerulonephritis?

Glomerulonephritis is unavoidable in many cases. People who have glomerulonephritis can make small changes to lessen their symptoms and prevent another episode from occurring. Basic tips for glomerulonephritis recovery and prevention include:

• Reduce salt intake
• Reduce potassium intake
• Reduce protein intake
• Maintain a healthy weight
• Quit smoking

Certain lifestyle changes might help prevent condition-specific cases of glomerulonephritis, including:

• Keep high blood pressure under control. This reduces the chance of hypertension causing kidney damage.
• Keep blood sugar under control to prevent diabetic nephropathy.
• Treat strep infections that cause a sore throat or impetigo.
• Practice safe sex and do not use intravenous drugs to reduce chance of developing glomerulonephritis from hepatitis or HIV.

Should you see a doctor for glomerulonephritis?

Yes, you should see a doctor for glomerulonephritis. Schedule a doctor’s appointment as soon as you develop any concerning symptoms. Not all cases of glomerulonephritis present similarly. A dedicated care team can help you formulate a streamlined treatment plan that meets your specific needs.

What is the outlook for people living with glomerulonephritis?

People who have glomerulonephritis must see a doctor for routine kidney checks. Ultimately, the outlook for people living with glomerulonephritis depends on which type of glomerulonephritis they have and how early they begin treatment. If a care team catches acute glomerulonephritis early enough, the effects are typically treatable and reversible.

Effective treatment can slow cases of chronic glomerulonephritis. Whether acute or chronic, serious cases of glomerulonephritis can progress into limited kidney function, chronic kidney failure, and end-stage renal disease. A person with glomerulonephritis that leads to severe kidney damage, kidney failure, or end-stage renal disease will likely need to undergo dialysis and a kidney transplant.