Glomerulonephritis is the third leading cause of end-stage kidney disease in the United States. Also known as nephritis and nephrotic syndrome, this disease damages the filtering units of the kidneys called the glomeruli. As the kidney becomes damaged, it is not able to remove wastes and extra fluid from the body. If the damage progresses, the kidneys may eventually stop working altogether, resulting in complete kidney failure.

Causes of Glomerulonephritis include:

  • Focal segmental glomerulosclerosis
  • IgA nephropathy (Berger's disease)
  • Lupus nephritis
  • Membranous glomerulonephritis
  • Mesangial proliferative disorder
  • Nephritis associated with disorders such as amyloidosis, multiple myeloma, or immune disorders, including AIDS

What are the symptoms of Glomerulonephritis?

Glomerulonephritis can be acute or chronic. The acute form develops suddenly. This is usually caused after an infection in your throat, such as strep throat, or an infection on your skin. Other illnesses such as lupus, Goodpasture’s syndrome, Wegener’s disease, and microscopic polyangiitis are also causes. Sometimes, the injury clears up on its own. Other times, your kidneys may stop functioning unless the illness is treated.

The early symptoms of the acute disease are:

  • Morning facial puffiness
  • Blood in your urine (aka hematuria)
  • Urinating less frequently than usual

In addition, your blood pressure may increase and you may have shortness of breath and coughing due to extra fluid in your lungs. If one or more of these symptoms, you should consult your physician.

Chronic Glomerulonephritis may develop over several years. It can often lead to complete kidney failure. Sometimes, the disease is hereditary and is passed down from generation to generation. The cause of chronic Glomerulonephritis is often unknown. Some forms are thought to be caused by problems with the immune system. Sometimes, patients will have an acute attack of the disease and develop the chronic form years later.

Some early signs and symptoms of the chronic form may include:

  • Blood in the urine (hematuria) or foamy urine indicating the presence of protein (proteinuria)
  • High blood pressure
  • Ankle swelling or swelling of the face (edema)
  • Frequent nighttime urination
  • Very bubbly or foamy urine

If chronic Glomerulonephritis persists, it will result in kidney failure. Symptoms of kidney failure include:

  • Lack of appetite
  • Nausea and vomiting
  • Tiredness
  • Difficulty sleeping
  • Dry and itchy skin
  • Nighttime muscle cramps

How is Glomerulonephritis diagnosed?

Early stages of Glomerulonephritis are first diagnosed by signs and symptoms, with the most apparent being protein and blood cells in your urine. Your physician will use urine and blood tests to help determine what type of illness you have and any degree of damage done to your kidneys.

Sometimes, your physician will request a kidney biopsy (aka renal biopsy). With a biopsy, a tiny portion of your kidney is removed with a needle and sent to a laboratory to be examined under a microscope by renal pathologists. This test will help in confirming your physician’s diagnosis and give him/her the information needed for prescribing the proper treatment.

Treatment for Glomerulonephritis

There is no specific treatment for the chronic form of the illness. Glomerulonephritis is treated by decreasing the inflammation of the glomeruli. Medications called corticosteroids (often prednisone or methylprednisilone) are most frequently used to treat this disease. Because these corticosteroids are non-specific anti-inflammatory agents, they can affect other parts of the body. Despite corticosteroids being effective, in many patients high doses for prolonged periods can have significant side affects including: weight gain, hyperglycemia, destruction of bones, easy bruising, and thinning of the skin.

In addition, your doctor may tell you to:

  • Eat less protein, salt and potassium
  • Control your blood pressure
  • Take diuretics (water pills) to treat puffiness and swelling
  • Take calcium supplements

The acute form may go away on its own. Antibiotics are not used to treat acute glomerulonephritis, but are important in treating other forms of disease related to bacterial infection.

How is Glomerulonephritis prevented?

Prevention of acute glomerulonephritis is unknown and will not be until more is known about its causes. Preventing viral infections such as HIV and hepatitis and certain bacterial infections can reduce factors that could lead to this illness.

For patients with chronic glomerulonephritis, it is very important to control your blood pressure. Your doctor or a dietitian trained to work with kidney patients (a renal dietitian) can be very helpful in planning a diet helpful in slowing down the effects of the disease.