Glomerulonephritis
What is it?
Glomerulonephritis is an inflammation of the kidney’s
filtering mechanisms, called the glomeruli.
Glomerulonephritis can be acute, which means it occurs
suddenly, or chronic, meaning symptoms develop gradually
and continue over a number of years.
Who gets it?
Acute glomerulonephritis is more common in children
between the ages of 2 and 12, particularly boys. Children
with frequent streptococcal infections are at a higher
risk of developing acute glomerulonephritis. Chronic
glomerulonephritis is more common in people with diseases
such as hepatitis, lupus, or diabetes.
What causes it?
Acute glomerulonephritis often occurs after a
streptococcal infection, such as strep throat. When this
is the cause, the condition is called acute
poststreptococcal glomerulonephritis (APSGN), or
postinfectious glomerulonephritis. It can also occur when
certain toxins, such as paints or glues, are inhaled and
then excreted through the urine. While chronic
glomerulonephritis occurs as a symptom of certain
diseases, its cause is not known.
What are the symptoms?
Many people with glomerulonephritis have no symptoms.
When symptoms occur, they are often flu-like, such as
general fatigue, nausea, vomiting, loss of appetite,
fever, and abdominal and joint pain. These types of
general symptoms can continue for up to one month before
symptoms of kidney failure appear. Patients whose kidneys
are failing will produce only small amounts of urine and
have swelling (edema) from fluid build-up. Symptoms of
acute glomerulonephritis usually occur around two to three
weeks after a streptococcal infection and begin with
swelling. They can progress to high blood pressure, visual
disturbances, shortness of breath, blood in the urine, and
a reduction in urine production. Chronic
glomerulonephritis develops so gradually that it is often
not discovered until a routine physical exam. As this
condition progresses, it causes high blood pressure,
swelling, and other symptoms of kidney failure.
How is it diagnosed?
To diagnose glomerulonephritis, your doctor will take a
complete medical history, perform a thorough physical
examination, and order some laboratory tests. He or she
will check a urine sample for blood and high levels of
protein. Your doctor will also check for high levels of
the waste products creatinine and urea in your blood. If a
streptococcal infection is suspected, additional tests of
the blood, as well as a throat culture, will reveal this
bacteria. Your doctor may also take a small sample of
kidney tissue, called a biopsy, to study under a
microscope. An eye exam may show signs of vascular changes
in people with chronic glomerulonephritis.
What is the treatment?
Acute glomerulonephritis is treated with bedrest and
medications to cure any infection, increase urine output,
and lower blood pressure, as necessary. It is important to
relieve any strain on the kidneys so they can recover full
function. Your doctor may also recommend changes to your
diet to control your intake of sodium, protein, and
fluids. Most children recover fully, although it may take
anywhere from several weeks to months. Adults may take a
bit longer. There is currently no treatment to stop the
progression of chronic glomerulonephritis. Once kidney
failure has occurred, waste products must be removed from
the bloodstream for the kidneys through a process called
dialysis. A kidney transplant may also be an option.
Self-care tips
You can help prevent acute glomerulonephritis by
treating streptococcal infections promptly, following the
full course of medication prescribed by your doctor.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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