Glomerulonephritis (GN) is inflammation of the glomeruli, which
are structures in your kidneys that are made up of tiny blood vessels. These
knots of vessels help filter your blood and remove excess fluids. If your
glomeruli are damaged, your kidneys will stop working properly and you can go
into kidney failure.
Glomerulonephritis is a serious illness that can be life-threatening
and requires immediate treatment. The condition is sometimes called nephritis.
There can be both acute (sudden) glomerulonephritis and chronic (long-term or recurring)
Are the Causes of Glomerulonephritis?
Glomerulonephritis (GN) can be acute or chronic.
Acute GN can be a response to an infection such as strep throat
or an abscessed tooth. It may be due to problems with your immune system
overreacting to the infection. This can go away without treatment. If it
doesn’t go away, prompt treatment is necessary to prevent long-term damage to
your kidneys. Illnesses that have been known to trigger acute GN include:
- strep throat
- systemic lupus erythematosus (SLE), which is
also called lupus
- Goodpasture’s syndrome, which is a rare
autoimmune disease in which antibodies attack your kidneys and lungs
- amyloidosis, which occurs when abnormal proteins
that can cause harm build up in your organs and tissues
- Wegener’s granulomatosis, which is a rare
disease that causes inflammation of the blood vessels)
- polyarteritis nodosa, which is a disease in
which cells attack arteries
Heavy use of non-steroidal anti-inflammatory drugs (NSAIDs), such
as ibuprofen and naproxen, may also be a risk factor.
The chronic form of GN can develop over several years with no or
very few symptoms. This can cause irreversible damage to your kidneys and ultimately
lead to complete kidney failure.
A genetic disease can sometimes cause chronic GN. Hereditary
nephritis occurs in young men with poor vision and poor hearing.
Immune diseases may also cause chronic GN. A history of cancer
may also put you at risk. Having the acute form of GN may make you more likely
to develop the chronic form later on. Exposure to some hydrocarbon solvents may
increase the risk of chronic GN.
Chronic GN doesn’t always have a clear cause. Twenty-five percent
of people with the condition have no history of kidney disease.
Are the Symptoms of Glomerulonephritis?
Early symptoms of acute GN include:
- puffiness in the face (edema)
- urinating less often
- blood in your urine (dark, rust-colored urine)
- extra fluid in your lungs, causing coughing
- high blood pressure
The chronic form of glomerulonephritis can creep up without any
symptoms. There may be slow development of symptoms similar to the acute form.
Some symptoms include:
- blood or excess protein in your urine, which may
be microscopic and show up in urine tests
- high blood pressure
- swelling in ankles and face (edema)
- frequent nighttime urination
- bubbly or foamy urine (from excess protein)
- abdominal pain
- frequent nosebleeds
Your GN may be so advanced that you’re developing kidney failure.
You may have some of the following symptoms:
- lack of appetite
- nausea and vomiting
- dry, itchy skin
- muscle cramps at night
Is Glomerulonephritis Diagnosed?
The first step in diagnosis is to have a urinalysis test. A
routine physical exam for another condition can also lead to the discovery of
GN. Blood and protein in the urine during urinalysis are important markers for
More urine testing may be necessary to check for important signs
of kidney health, including:
- creatinine clearance
- total protein in the urine
- urine concentration
- urine specific gravity
- urine red blood cells (RBCs)
- urine osmolality
Blood tests may show:
- anemia, which is a low level of red blood cells
- abnormal albumin levels
- abnormal blood urea nitrogen
- high creatinine levels
Immunology testing can also check for things, such as:
- antiglomerular basement membrane antibodies
- antineutrophil cytoplasmic antibodies
- antinuclear antibodies
- complement levels
These are all signs that your immune system may be damaging your
A biopsy (a small sample taken with a needle) of the kidneys may
be necessary to confirm the diagnosis.
To learn more about your condition, you may also have scans such
- CT scan
- kidney ultrasound
- chest X-ray
- intravenous pyelogram (X-ray of kidneys with
Treatments Are Available for Glomerulonephritis?
Depending on the type of GN, the cause and treatment may be
One treatment is to control high blood pressure, especially if
that’s the underlying cause of the GN. Blood pressure may be very hard to
control when your kidneys aren’t working properly. If this is the case, your
doctor may prescribe blood
pressure medications, including angiotensin-converting enzyme inhibitors
(ACE inhibitors) such as:
Your doctor may also prescribe angiotensin receptor blockers
(ARBs), such as:
also be used if your immune system is attacking your kidneys. They reduce the
Another method to reduce the immune-triggered inflammation is plasmapheresis. This process removes the
fluid part of the blood (plasma) and replaces it with intravenous (IV) fluids
or donated plasma (with no antibodies).
For chronic GN, you’ll need to reduce the amount of protein, salt, and potassium in your diet.
Additionally, you must watch how much liquid you drink. Calcium supplements may
be recommended, and you may need to take diuretics to reduce swelling. As
usual, check with your general practitioner or kidney specialist for guidelines
about diet restrictions or supplements.
If your condition becomes advanced and you develop kidney
failure, you may need to have dialysis.
This is a procedure where a machine filters your blood. Eventually, you may
need a kidney transplant.
Are the Complications Associated with Glomerulonephritis?
Glomerulonephritis can lead to nephrotic syndrome, where you lose
large amounts of protein in your urine. This leads to a lot of fluid and salt retention
in your body. You can develop high blood pressure, high cholesterol, and
swelling throughout your body. Corticosteroids treat this condition. Eventually,
nephrotic syndrome will lead to end-stage renal disease if it doesn’t come
The following conditions can also occur due to GN:
- acute kidney failure
- chronic kidney disease
- electrolyte imbalances, such as high levels of
sodium or potassium
- chronic urinary tract infections
- congestive heart failure due to retained fluid
or fluid overload
- pulmonary edema due to retained fluid or fluid
- high blood pressure
- malignant hypertension, which is rapidly
increasing high blood pressure
- increased risk of other infections
Is the Long-Term Outlook?
Acute GN, if caught early, can be temporary and reversible.
Chronic GN may be slowed with early treatment. If your GN worsens, it will
likely lead to reduced kidney function, chronic kidney failure, and end-stage
Severe kidney damage, kidney failure, and end-stage renal disease
may eventually require dialysis and the need for a kidney transplant.
The following are positive steps to recover from GN and prevent
- maintaining a healthy weight
- restricting salt in your diet
- restricting protein in your diet
- restricting potassium in your diet
- quitting smoking
Meeting with a support group can also be a helpful way for you to
deal with the emotional stress of having a kidney disease.