Kidney diseases

Glomerulonephritis

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Glomerulonephritis
portrait of Clara Boter Carbonell Ph.D.
Written by

Clara Boter Carbonell Ph.D.
Medically reviewed by our Medical staff

Last update: 16-09-2022

How else can it be called?

  • Glomerular disease

  • Chronic nephritis

  • Glomerulopathy

  • Glomerular nephropathy

  • CIE-10: N05

What is glomerulonephritis?

Glomerulonephritis is a term referred to the inflammation of the renal glomeruli. The glomerulus (in plural glomeruli) is a part of the kidney where the blood is filtered.

In each kidney there are between 800.000 to 1 million glomeruli.

Glomerular damage can develop quickly (acute nephritic syndrome) or slowly (chronic nephritic syndrome).

What are the main causes of glomerulonephritis?

Glomerulonephritis is usually caused by an autoimmune disorder. The immune system is usually the responsible for the inflammation of the glomeruli. There are some risk factors that may trigger the immune system to overreact causing the disease:

  • Previous bacterial or viral infections
  • Autoimmune diseases
  • Vasculitis (inflammation of the blood vessels)

What are the main symptoms of glomerulonephritis?

Inflammation of the glomeruli results in a volume decrease of filtered blood or a in a loss of important molecules. This causes a decrease in urine production and the excretion in the urine of substances that should not be excreted.

The symptoms caused by this process are:

  • Blood in the urine (hematuria)
  • A high level of protein in the urine (proteinuria)
  • Fluid retention or swelling (edema) in different parts of the body (face, hands, feet, ankles) as a consequence of the accumulation of plasma in the tissues due to a decrease in blood proteins.
  • Low urine output (oliguria) or frequent urination
  • Anemia that may be observed as pale skin and mucous membranes
  • Fatigue
  • Headache
  • High blood pressure
  • Shortness of breath

Over time, this contributes to the scarring of the glomeruli and to the irreversible loss of their functionality. Finally, this process may lead to chronic kidney failure.

How can it be diagnosed?

Most of the glomerulonephritis are chronic and progress slowly. The disorder is usually discovered on a routine urinalysis or another screening test.

The final diagnosis is the kidney biopsy, where a small piece of the kidney tissue is taken to be examined under the microscope.

Other tests that may be helpful are:

  • Imaging tests (CT, kidney ultrasound, chest X-ray, etc.)
  • Urinalysis
  • Blood test

What is the recommended treatment?

Most of the glomerulonephritis are caused by an autoimmune disorder. For that reason, the most common drugs used to slow the progression of the disease are immunosuppressants such as:

  • Corticosteroids (used as first choice)
  • Cyclophosphamide
  • Chlorambucil
  • Rituximab

Another way to decrease the immune system attack is plasmapheresis. Plasmapheresis is a process to separate the plasma (liquid part of the blood) from the blood cells. This process is used to remove antibodies from the blood and add plasma from a donor. In this way, the antibodies that cause the kidney inflammation are removed from the blood. This technique can only be applied to certain subtypes of glomerulonephritis.

On the other hand, it is essential to treat the high blood pressure to slow the progress of the disease. It is important to avoid a kidney failure and to reduce the damage to other parts of the body affected by high blood pressure.

Finally, the medical treatment should be complemented with a diet to reduce the renal effort. Some measures recommended for this purpose are water intake restriction, a low-sodium diet or a reduction in the intake of proteins and toxic substance (some medication) for the kidney.

If the disease progress to kidney failure over time, the only possible treatment is dialysis or a kidney transplant.

What is the prognosis of the disease?

Depending on the severity of glomerulonephritis, it can be reversible or become chronic leading to a kidney failure.

Medically reviewed by our Medical staff on 16-09-2022

Bibliography

  • Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.
  • First Aid for the Basic Sciences: Organ Systems (3rd Ed) 2017, Tao Le, William L. Hwang, Vinayak Muralidhar, Jared A. White and M. Scott Moore, ISBN: 978-1-25-958704-7, Pag. 627.
  • Urinalysis and Body Fluids. Susan King Strasinger. Marjorie Schaub Di Lorenzo. 5th edition. 2008. ISBN 978-0-8036-1697-4 Pag. 144.

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