Glomerulonephritis

1 What is Glomerulonephritis?

Glomerulonephritis is an inflammatory condition which affects the tiny filters in the kidney (Glomeruli).

This helps in the removal of the excess fluids, electrolytes and body wastes from the blood stream which can be able to pass through the urine.

They are also called the glomerular disease glomerulonephritis can be both acute and chronic. Acute disease is characterized by a sudden inflammation of the glomeruli while chronic comes gradually.

When it comes on its own, it is known as glomerulonephritis. In case It comes with another effect such as lupus or diabetes, it is referred to the secondary glomerulonephritis. Severe or prolonged inflammation of the glomeruli can be associated with the damage of the kidneys.

The treatment is varied in relation to the type of the glomerulonephritis one has.

2 Symptoms

Symptoms of glomerulonephritis vary from mild to severe, so it is important to discuss with your doctor.

Glomerulonephritis can be either acute or chronic depending with the cause.

One will know that there is something wrong from the symptoms or from the analysis. The signs and symptoms include the presence of pink or coca cola colored urine as a result of the presence of the red blood cells in the urine (hematuria).

It can also be formy as a result

  • the excess proteins (proteinuria),
  • high blood pressure hypertension,
  • excessive fluid retention leading to edema with evidence of swelling of the face, hands, feet and abdomen.
  • Fatigue may also be observed from anemia or failure of the function of the kidney.

It is important for one to see a doctor promptly.

3 Causes

There are many factors that cause glomerulonephritis although in somecases, the cause of the disease may not be known.

Some of the conditions that lead to the inflammation of the glomeruli includes: infections such as post streptococcal glomerulonephritis. This occurs normally about two weeks after the strep throat infection or some skin infection (Impetigo).

As a result of the body’s defense system, your body produces antibodies that settle in the glomeruli which may be responsible for the inflammation. This is common among the children than in the adults; they also have better chances of quick recovery than adults.

It can also occur during bacterial endocarditis when bacteria spread through your blood stream. This may promote the lodging of the bacteria in one of the heart valves leading to an infection.

This exposes one to the risk of developing a heart condition such as damage of a heart valve or use of an artificial heart valve. Bacterial endocarditis is associated with glomerular disease. However, there has been no direct link between the two diseases.

Viral infections can also lead to human immunodeficiency virus (HIV), hepatitis B and C and possibly, glomerulonephritis.

An immune disease; lupus is a chronic inflammatory disease which  can affect many parts of the body including the skin, joints, kidneys, blood cells, heart and lungs. Similarly, an immunological disorder referred to as the good pasture’s syndrome is a rare immune disorder affecting the lungs and may mimic pneumonia.

This condition causes the bleeding of the lungs and glomerulonephritis. IN addition, it can initiate IgA nephropathy which is characterized by frequent presence of blood in urine. This induces the primary glomerular nephritis disease and results from the deposition of the immunoglobulin A in the glomeruli.

This condition can progress for several years with no signs and symptoms. It can also lead to vasculitis polyarthritis which is a vascular disease and affects both the small and medium blood vessels in the many parts of the body. It may affect the heart, kidney, and intestines.

This may lead to conditions such as Wegener’s granulomatosis which is a form of vasculitis that affects both the small and medium blood cells in the lungs, upper region of the airways and kidney. This condition may lead to the scarring of the glomeruli leading the high blood pressure.

High blood pressure also damages the kidney and impairs their ability to function normally. Loss of the kidney function may also lead to high blood pressure since it impairs with the homeostasis of sodium. Diabetes kidney disease (nephropathy) can also affect anyone suffering from diabetes.

It may take several years to develop and proper control of the blood sugar and blood pressure may lower the risks of developing kidney damage or even slow the process. Focal segmental of glomerulosclerosis is indicated by scarring of the glomeruli which may start from another condition or disease that may be from an unknown condition.

However, chronic form of the glomerulonephritis may also develop after an acute glomerulonephritis. There may be no history of the kidney disease in the family. However, the first chronic sign of glomerulonephritis is kidney failure.

This may sometimes run in families. Another inherited risk factor is the Alport syndrome which may in the process impair with the hearing and vision. Infrequently, chronic glomerulonephritis runs in families. One inherited form, Alport syndrome, also may involve the impairment of hearing or vision.

4 Making a Diagnosis

Making a diagnosis of glomerulonephritis is done by performing several tests.

When you discover the signs and symptoms of the kidney diseases, see a doctor immediately. A doctor may need to use a few laboratory tests to identify the nature and extend of the kidney damage.

You may also be referred to a nephrologist. When seeking for an appointment to see a doctor. Ask for information in advance on what you may need ahead of time.

This may include things like limiting your diet, preparing a list of your symptoms for both related and unrelated to the kidney disease.

The medication and their doses for the vitamins, supplements and any other prescriptions and non-prescriptions. Consider understanding your medical history.

Moreover, prepare a list of questions to ask your doctor. List the most important ones to least important. Always take a family member with you. Some of the basic questions may include:

  • How badly is my kidney affected?
  • What tests will I require?
  • Is my condition temporary?
  • Will I require any form of dialysis?
  • Do I have any other associated medical condition?
  • Are there any forms of restrictions I need to observe?
  • Do I need to see a specialist for this condition?
  • Are there better alternatives to the treatment I am receiving?
  • Are there information I need for this condition?

One also need to expect a set of questions from the doctor, probably, almost similar to the one’s you had prepared. They may include:

  • when did the symptoms begin?
  • How do the symptoms progress?
  • Is there anything that improves or makes it worse?
  • Is there anyone in your family with the same condition?
  • Do you have a history of high blood pressure or diabetes?

The use of the signs and symptoms may offer an indication of glomerulonephritis; this may be followed by routine analysis to assess the abnormality of the tests.

Kidney function tests can be done to make a diagnosis of the glomerulonephritis. Urine test may indicate the presence of red blood cells and red cells casts in urine which suggests the possibility of damage of the glomeruli. White blood cells may be also be observed in urine, an indication of an infection or inflammation and increased proteins and nephron damage.

Other indicators may include the detection of creatinine or urea in blood samples. Blood tests can also be done to find information on the status of the kidney damage and impairment of the glomeruli by determining the concentration of the waste products such as creatinine and blood urea nitrogen.

Imaging tests for visualization of the kidney’s using X-rays, CT scan and Ultrasound can be used for evaluation of damage. Kidney biopsy may be done using a special needle to extract a small piece of the kidney tissues for use in microscopic examination as a way of determining the cause of inflammation.

In some cases, it is very necessary to confirm the diagnosis of the glomerulonephritis. 

5 Treatment

Treatment of glomerulonephritis will vary depending on whether one has acute or chronic form of the disease. This will also vary with the type and severity of the symptoms presented in the disease.

For instance, glomerulonephritis that follows the strep infection always tends to improve on its own and may not need any form of specific treatment. The main goal of treatment is to protect the damage of your kidney’s.

In the management of high blood pressure, putting the high blood pressure under control is very key in the protection of the kidney’s. One needs to control the high blood pressure and then slow down the damage to the kidney.

This may be achieved by the use of several forms of drugs such as diuretics, angiotensin converting enzyme (ACE) inhibitors, angiotensic II receptor blockers, and treatment of the kidney infection causing the inflammation.

Your doctor may also determine other best procedures of controlling hypertension. Treatment helps in the easing of the signs and symptoms.

An appropriate antibiotic may also be prescribed.

In the management of Lupus and vasculitis, the doctors will often prescribe corticosteroids and other immune suppressing drugs to manage the inflammations.

IgA nephropathy is also managed by fish oil supplements and immune suppressing drugs.

Plasmapheresis is used in the treatment of people with good pasture syndrome.

This is a process by which the antibodies are removed from your body and replaced with other fluids or donated blood plasma.

Therapies for acute kidney failure can also be given.

Dialysis can also be done to remove excess fluids and regulate the high blood pressure.

Long term therapies for end term kidney disease is often kidney dialysis or kidney transplant

6 Prevention

There is no known way of preventing the common forms of glomerulonephritis.

However, it may be beneficial to seek prompt treatment of infections such as strep infections which causes a sore throat or impetigo.

Also, prevent infections that may lead to glomerulonephritis such as HIV, hepatitis, and follow a safe sex guideline. Avoid the use of intravenous use of drugs.

Manage the high blood pressure which will reduce the likelihood of kidney damage as a result of hypertension.

Manage your blood sugar to reduce the chances of diabetic nephropathy.

7 Lifestyle and Coping

In case one is suffering from glomerulonephritis, it will be recommended that one have a lifestyle change.

This may include a reduction in the intake of salt to reduce fluid retention, swelling and hypertension.

Also, lower the intake of proteins and potassium to reduce the build up process of the wastes in the blood stream and keep a healthy weight. Check on the blood sugar to prevent developing diabetes.

Avoid smoking. This will lower the potential of developing chronic illnesses which tax on the emotional resources.

Join support groups to gain both in experience and knowledge provided by the teams. They also provide sympathetic listening and useful knowledge on how to manage the condition. Request your doctor to provide you with contacts of the support groups in your locality.

8 Risks and Complications

There are several risks and complications associated with glomerulonephritis.

Glomerulonephritis leads to the damage of your kidneys and may lead to the destruction of the filtering ability.

Consequently, dangerous levels of fluids, electrolytes and wastes can build up in your body. Some of the complications may include:

  • acute kidney failure,
  • loss of filtering function of the kidney nephron,
  • accumulation of the waste products in the kidney.

An emergency dialysis may also be needed to remove the extra fluids and wastes from the blood stream. A dialysis machine is simply an external kidney.

When under chronic conditions, the kidney filtering ability is greatly reduced, when the function reduces to less than 10%, this is referred to as end stage kidney disease.

This requires that a dialysis be used or transplant of the kidney be carried out to protect life. High blood pressure may develop as a result of the accumulation of the wastes in the blood stream.

Nephrotic syndrome is also an indication that one has a lot of proteins in the urine, this result in very little proteins in the blood. This is sometimes associated with high blood levels of cholesterol and swelling of the face, abdomen, hands and feet.

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