Nephrologist (Kidney Specialist) Questions Glomerular disease

My mother has been diagnosed with glomerular disease. How is it treated?

My mother is 70 years old and has been diagnosed with glomerular disease. We all haven't heard of it before, so we aren't sure how she would recover from this and the overall treatment. Can you please tell us what we should expect?

4 Answers

Each kidney is composed of ~1 million functional units called “nephrons”. The first part of the nephron is the “glomerulus” or filter. “Glomerular disease” pertains to issues with the glomerulus. There are a number of different types of glomerular diseases with a variety of different treatments.
Depending on the specifics of your mother’s clinical situation, it may be appropriate for her to have a kidney biopsy. I strongly suggest that your mother see a nephrologist (kidney specialist) who can evaluate her & determine what specific treatment(s) is/are most likely to benefit her.

Steven A. Burka, MD, FACP, FASN
The treatment for glomerular disease depends on what specific type of glomerulonephritis (GN) she has. Did she have a kidney biopsy that confirmed the glomerular disease? Most GN's are treated with high-dose corticosteroids and immunosuppressive medications (either given IV or orally). If there is active inflammation in the kidneys, she will probably need to be admitted to the hospital for IV steroids given for 3 days, followed by initiation of another immunosuppressant medication. These meds increase risk for infections, but are critical for reducing the damage that inflammation is doing in the kidneys. The high dose steroids will be tapered gradually after she starts the alternative immunosuppressant medication, typically over months, depending on the disease response. She will likely need to take a special antibiotic for prevention of a rare pneumonia that people on immunosuppressants are at increased risk for, as well as Ca + Vit D supplements to prevent osteoporosis from steroids. She will need very close monitoring of labs and follow-up in the clinic at least every 3 months (possibly more often initially). Without knowing more details of the case, I cannot comment on exactly what to expect, but these are general guidelines assuming this is an active GN. 
Best wishes to you and your mother for a successful treatment outcome!

Sincerely,

Kelly Liang, MD, MS, FASN
Treat according to the biopsy
What has the doctor told you about the diagnosis. There is a wide spectrum of glomerular disorders. Some are primary and other secondary to underlying diseases. I can guide you once you get that answer from your doctor. Did your mom have a kidney biopsy? If so, the answer will be easier to give. Update the data here and I can give you suggestions regarding management