Glomerulonephritis
What is Glomerulonephritis?
Glomerulonephritis (also called Nephritis) is a group of disorders inflaming the miniscule filters in the kidneys that remove excess wastes, fluid and electrolytes from the bloodstream.
The condition can be sudden and acute (often after a throat or skin infection), or chronic which develops silently over many years.
Glomerulonephritis can often be a disease on its own or a part of other disease such as Diabetes or Lupus.
Many types of Nephritis are caused by the body’s immune system responding to a “kidney insult” of some description.
This can be a drug, medication or poison, or a viral or bacterial infection.
Nephritis can also run in families and other causes include Diabetic Kidney Disease, Vasculitis (blood vessel disease), Immune disease such as Lupus, IgA Nephropathy (that causes blood in the urine).
Some forms of Nephritis can be mild at first but may cause high blood pressure later.
The condition can vary from mild and non-damaging for many, while less commonly may cause kidney failure requiring dialysis.
What are the different categories for Glomerulonephritis?
Nephritis is generally categorised into three categories:
1 Focal Nephritis – This group includes IgA Nephritis, also called IgA Nephropathy, which is the most common type of Nephritis in Australia today.
In this case, scarring impacts less than 50% of the filters. Red blood cells and a mild level of protein is present.
Generally signs of more severe disease are not present and sometimes protein and blood are discovered only during routine tests.
2 Diffuse Nephritis – This is when there are higher levels of protein in urine; most of the filters are affected and there is swelling of the limbs and face along with high blood pressure.
3 Nephrotic Syndrome – This is when damage to filters causes them to leak large amounts of protein into the urine, which means the body is depleted of protein.
Swelling of the tissues occurs and cholesterol rises in the blood.
In children, Nephrotic Syndrome is usually due to Minimal Change Disease (only very mild abnormalities of the glomeruli).
Minimal change disease can sometimes occur in adults as a result of medication or cancer.
What are the symptoms of Glomerulonephritis?
Symptoms of Glomerulonephritis include:
- Pink or dark coloured urine (Hematuria)
- Foamy urine, due to excess protein
- High Blood Pressure
- Swelling of the face, hands, feet and stomach
Very often, Nephritis is not detected until damage is significant or is found in routine health checks.
How is it diagnosed?
Glomerulonephritis is diagnosed by blood tests to assess kidney function. Estimated Glomerular filtration rate or eGFR is the general indicator for kidney functionality.
Urine tests will also check for a protein known as albumin.
A dipstick test may be used for blood detection in the urine.
More tests may be needed such as a kidney biopsy where a tiny piece of kidney tissue is removed and examined under a Microscopic, or imaging such as Ultrasound, CT, X-Ray or MRI.
What is the treatment for Glomerulonephritis?
- Many types of nephritis will need no treatment at all and in many cases will not lead to any long term damage.
- Treatment will depend on the underlying cause and whether you have an acute or chronic form of the disease.
- Some people may need life-long blood pressure medication which can reduce portion and decrease blood pressure at the same time.
- Sometimes water pills (diuretics) will be prescribed.
- Restricting salt will minimise swelling and fluid retention
- Consuming less protein and potassium can slow the buildup of wastes in the blood.
- Smoking significantly worsens outcomes, so it is important to speak to your doctor about dedicated smoking cessation options if you smoke.
- Medications that prevent the immune system from attacking the kidneys can be used in some cases.
- Regular kidney check-ups and blood pressure monitoring can prevent and delay further problems with your kidneys.