Glomerulonephritis
Glomerulonephritis is an inflammatory condition that affects the kidneys, impairing their ability to filter waste and excess fluid from the body. This condition can manifest in two forms: acute, which occurs suddenly and is often treatable, and chronic, which develops gradually and may lead to permanent kidney damage. The kidneys play a crucial role in filtering out waste, toxins, and excess substances, creating urine for excretion. In glomerulonephritis, inflammation of the glomeruli—the small blood vessels responsible for this filtration—hinders this process.
The causes of glomerulonephritis can include infections, autoimmune diseases, and inherited conditions. Symptoms vary based on the form of the disease, with chronic cases sometimes exhibiting few symptoms until advanced stages are reached, while acute cases may present with noticeable changes in urine and swelling. Diagnosis typically involves urine and blood tests, and treatment approaches differ between the acute and chronic forms, focusing on managing symptoms and underlying causes. While recovery is common with acute glomerulonephritis, chronic cases require ongoing management to prevent progression to kidney failure. Preventative measures focus on controlling risk factors and treating infections promptly to reduce the likelihood of developing this condition.
Glomerulonephritis
Glomerulonephritis (pronounced glow-mer-you-low-nef-RYE-tis) refers to a group of inflammatory diseases that affect the kidneys' ability to filter waste and extra fluid from the body. It can be acute, meaning it occurs suddenly, or chronic, meaning it comes on gradually and lasts a long time. Acute glomerulonephritis is more easily treated and can be cured. Chronic glomerulonephritis is more likely to be permanent and can lead to kidney failure. It cannot be prevented, but it is possible to reduce the chances of acquiring the condition by taking steps to avoid several diseases that can lead to glomerulonephritis.
Background
The kidneys are a pair of organs located low on the back. Each fist-sized organ helps remove waste from the body. This waste includes excess salt, potassium, uric acid, and other materials that the body has not metabolized, or used for energy to carry out bodily processes. It also includes toxins and poisons that may be ingested as well as excessive amounts of vitamins, minerals, and other substances that the body does not need. The kidneys also process extra fluid and remove it from the blood stream. All of these are filtered through the kidneys and turned into urine, which is excreted from the body.
Glomerulonephritis results when the glomeruli in the kidneys become inflamed. The word glomeruli comes from the Latin word glomus, which means "ball of yarn." This describes the appearance of the small blood vessels around tubing that form the glomeruli. The inflammation causes swelling that limits or prevents the glomeruli from properly removing the waste. Glomerulonephritis is also known as Bright's disease, nephritis, or nephrotic syndrome. Nephritis and nephrotic come from the Greek word nephros, which means "kidney."
Types and Causes
There are two types of glomerulonephritis: acute (or sudden onset) and chronic. The acute form occurs after an infection. Skin infections such as impetigo or throat infections such as strep throat cause the body to produce antibodies to fight these conditions. If too many antibodies are produced, they can attack the glomeruli and cause inflammation. This is most likely to happen in children, but children are also more likely to recover quickly from acute glomerulonephritis. Other conditions that can lead to acute glomerulonephritis include other infections, lupus and other autoimmune conditions such as Goodpasture syndrome, and Wegener's granulomatosis and other forms of vasculitis, or inflammation of the blood vessels.
Chronic glomerulonephritis can be an inherited condition. It can also result from weaknesses in the immune system. Damage to the kidneys from diseases such as high blood pressure, human immunodeficiency virus (HIV), hepatitis, and diabetes can also cause glomerulonephritis.
Complications
There are a number of complications that can result from glomerulonephritis. The condition can cause chronic kidney disease, in which the kidneys slowly lose the ability to filter any of the body's waste. This can cause the kidneys to completely stop functioning, which is known as kidney failure. Glomerulonephritis can be caused by high blood pressure but it can also cause high blood pressure, as fluids, salts, and other wastes build up in the blood stream and strain the circulatory system. It can also cause nephrotic syndrome, where the kidneys excrete too much protein and leave too little for the body.
Symptoms
The symptoms of glomerulonephritis vary based on whether the condition is acute or chronic. The chronic version may build slowly over years without any noticeable symptoms. It might only be detected by finding blood or excess protein during a urine test. Other conditions that might indicate chronic glomerulonephritis include high blood pressure, edema or swelling in the ankles and/or face, and frequent nighttime urination.
A person with either form of glomerulonephritis might have bubbly or foamy urine (caused by high protein levels), blood in the urine or urine that is brown or pinkish in color. People who have acute glomerulonephritis may urinate less often than normal and have facial puffiness in the morning.
If glomerulonephritis progresses to kidney failure, the patient may experience a number of new symptoms. These include loss of appetite, nausea and vomiting, difficulty sleeping and fatigue, skin dryness, and nighttime muscle cramps. The patient may also experience difficulty breathing as fluids build up in and around the lungs.
Diagnosis
Glomerulonephritis will be suspected if the patient exhibits any of these symptoms. This will especially be the case if the patient has experienced a recent infection or has had high blood pressure, an autoimmune condition, has used street drugs, or has HIV or hepatitis. The first test will be a urinalysis, where a sample of urine is collected and tested for evidence of blood or protein.
If these are present, the physician will order blood tests to determine what form of the condition is present and how far it has progressed. Another test that might be required is a kidney biopsy. For this test, a needle is inserted into the kidney to remove a small sample for testing.
Treatment
Sometimes the acute form of glomerulonephritis goes away without treatment, but it often requires medication. It could possibly require short-term treatment called dialysis, which uses a machine to remove waste products normally removed by the kidneys. In severe cases, the patient may need a treatment called plasmapheresis, which uses a machine to filter excess proteins from the blood.
The chronic form has no specific treatment that leads to a cure. Physicians usually recommend a diet that is low in protein, salt, and potassium and reducing fluid intake so there are fewer waste products to be removed. They will also suggest steps to help control blood pressure. They may also recommend pills called diuretics that remove extra water from the body to reduce any swelling.
Prevention
Researchers do not yet understand enough about glomerulonephritis to prevent it. However, they do know that avoiding the conditions that can lead to it or can damage the kidneys can help reduce the chances of acquiring it. This includes keeping blood pressure under control, not exceeding recommended doses of over-the-counter pain medicines, avoiding injected street drugs, and avoiding behaviors that can lead to HIV. In addition, getting prompt treatment for infections such as strep throat and impetigo and treating conditions such as vasculitis can help limit the chances of developing acute glomerulonephritis.
Prognosis
Most people with acute glomerulonephritis will recover fully and return to all normal activities. The outcome for those with chronic glomerulonephritis depends on how quickly the condition is caught. Those who are diagnosed early may limit the damage and live a relatively normal life. If the condition progresses, it can cause kidney failure. This usually requires dialysis and may necessitate a kidney transplant.
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