What is glomerulonephritis?
Glomerulonephritis is a progressive kidney illness that affects the glomeruli, which are the urine-producing filtering units of the kidney. When the glomeruli are inflamed, the kidneys cannot adequately filter urine. This causes an accumulation of fluid and poisons in the body. Chronic renal (kidney) failure may result from glomerulonephritis.
Primary and secondary glomerulonephritis are the two most common forms. In primary glomerulonephritis, the kidneys are directly affected, whereas in secondary glomerulonephritis, the kidneys are harmed due to another sickness. Glomerulonephritis appears to affect males twice as frequently as females.
Causes
Glomerulonephritis is frequently caused by an immune system disorder. Typically, the immune system protects the body from problems like illnesses by attacking and destroying the pathogens that cause them. However, occasionally the immune system might malfunction. Many cases of glomerulonephritis are caused by the body attacking itself in error, causing damage to the kidney’s glomeruli. It is not always clear why this occurs, although in certain situations, a trigger, such as an infection, can be discovered. The infection causes the immune system dysfunction and the glomerular damage.
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The most frequent illness that can cause glomerulonephritis is an infection caused by certain forms of streptococcal bacteria. This may occur following an upper respiratory illness or skin infection caused by these germs. Typically, glomerulonephritis symptoms appear between one and three weeks following the first infection. Additional bacteria, viruses, parasites, or fungus are also capable of causing glomerulonephritis. Glomerulonephritis caused by an infection can occur at any age, however it is more prevalent in children between 5 to 15 years old.
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Glomerulonephritis can also be precipitated by the use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). In rare cases, it may be difficult to determine the exact trigger or cause of glomerulonephritis.
Types
There are numerous forms of nephritis, including the following:
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- Acute glomerulonephritis: This form of nephritis can develop rapidly following a severe illness, such as strep throat, hepatitis, or HIV.
- Lupus and rarer conditions, including vasculitis and granulomatosis with polyangiitis (GPA), can also cause acute inflammation of the kidneys. In order to prevent kidney damage, a person with these disorders will require rapid medical intervention during an acute episode.
- Lupus nephritis: Lupus is an autoimmune illness, which means the immune system erroneously attacks healthy bodily tissues.
- More than half of those diagnosed with lupus will eventually develop lupus nephritis. When the immune system targets the kidneys, this occurs.
- These are the symptoms of lupus nephritis:
- Foamy urine
- Elevated blood pressure
- Swelling of the lower extremities
- Individuals may also experience symptoms in other regions of the body. Among these symptoms may be joint pain, fever, and rashes.
- Lupus might vary in severity amongst patients. Even though the disease occasionally enters remission, the condition might become severe. Anyone suffering signs of lupus nephritis must seek immediate medical care to prevent further kidney damage.
- Alport syndrome, also known as hereditary nephritis, can cause renal failure, as well as visual and hearing issues. Alport syndrome is genetically transmitted and is typically more severe in men.
- Chronic glomerulonephritis: This form of nephritis develops slowly and in its early stages generates minimal symptoms. This illness, like acute glomerulonephritis, can cause serious kidney damage and kidney failure. It may be inherited or result from a sudden illness.
- IgA nephropathy is one of the most prevalent types of nephritis. It occurs when IgA antibody deposits accumulate and induce inflammation in the kidneys.
- Antibodies are produced by the immune system to resist dangerous substances and organisms that enter the body. IgA neuropathy is characterized by deficient IgA antibodies.
- IgA nephropathy is rarely diagnosed in young patients because its early signs are easy to overlook. This issue can be treated with blood pressure medicines.
- Interstitial nephritis: This form of nephritis often develops swiftly and is typically caused by an infection or a certain medicine. It affects the interstitium, which is a fluid-filled area within the kidney.
- A full recovery is achievable within a few weeks if the harmful medicine is abruptly discontinued by a physician. However, sometimes enough damage can build to cause renal failure.
Risk Factors
- The cause of glomerulonephritis is frequently unknown, however, there are risk factors that can influence its chance.
- Post-streptococcal glomerulonephritis can be caused by streptococcal infections of the throat or, in extremely rare instances, impetigo, a skin infection. As a result of improved therapies for most streptococcal infections, this is now less prevalent.
- Tuberculosis (TB) and syphilis can cause glomerulonephritis. This is also true in endocarditis, an infection of the heart valves caused by bacteria. Additionally, viral diseases including HIV, hepatitis B, and hepatitis C enhance the risk.
- Acute glomerulonephritis can progress to chronic or long-lasting glomerulonephritis.
- Although genetic factors may play a role, patients with glomerulonephritis typically do not have a family member with the ailment.
- Certain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or aspirin, can raise the risk when used over an extended period of time.
- Individuals with Hodgkin’s disease, sickle cell anemia, and systemic disorders, particularly diabetes, are at a greater risk.
Symptoms
Glomerulonephritis frequently does not first manifest with symptoms. If the damage to your glomeruli persists, glomerulonephritis symptoms include:
- Blood in your urine, which can cause your urine to appear pink, red, or brown.
- Protein in your urine, which can create foamy or bubbly pee.
- Elevated blood pressure
- Anemia, which occurs when the body lacks sufficient red blood cells
- Inflammation of the face, eyes, ankles, feet, legs, or abdomen
- Feeling more exhausted than usual
If glomerulonephritis continues to worsen, it can cause major kidney complications, including:
- Acute kidney damage
- End-stage renal disease
- Syndrome of nephrotic syndrome (which is similar to but not the same as glomerulonephritis)
- Kidney ailment
- Fluid accumulation
- Hyperkalemia (high potassium)
- Renal failure
When to see a physician?
Consult a doctor if you observe blood in your urine. This may not usually indicate glomerulonephritis, but the underlying reason should be determined.
If a general practitioner suspects glomerulonephritis, they will typically:
- A blood test to determine your creatinine concentration
- A urine test to determine the presence of blood or protein
- If you have glomerulonephritis, you may require additional blood tests to determine the cause.
- If your kidney condition requires additional investigation, you may be advised to:
- An ultrasound to examine the size of your kidneys, ensure there are no blockages, and search for additional issues.
- A biopsy – a small sample of kidney tissue is removed using local anesthetic to numb the area; an ultrasound machine is used to locate the kidneys, and a small needle is used to obtain the sample.
Diagnosis
Glomerulonephritis can be diagnosed by testing if you have an acute sickness or during routine testing at a wellness visit or an appointment to manage a chronic illness, such as diabetes. The following tests are used to evaluate your kidney function and diagnose glomerulonephritis:
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- Urine test. A urinalysis can detect indicators of impaired kidney function, such as red blood cells and proteins that should not be present in urine as well as white blood cells that indicate inflammation. There may also be an insufficient amount of waste products.
- Blood testing. Blood sample analysis can reveal abnormally high quantities of waste materials in the bloodstream, the presence of antibodies that may suggest an autoimmune condition, bacterial or viral infection, or blood sugar levels that indicate diabetes.
- Imaging testing. If your physician notices signs of kidney illness, he or she may offer imaging tests that may reveal irregularities in the kidney’s size or shape. These tests may include X-rays, ultrasounds, or CT scans.
- Kidney biopsies. This process includes extracting small samples of kidney tissue for microscopic examination using a specialized needle. The purpose of a biopsy is to confirm a diagnosis and determine the extent and nature of tissue damage.
Treatment
Your healthcare professional will determine the optimal treatment depending on the following:
- Your current age
- Your general wellbeing and medical record
- How ill are you?
- Your ability to manage specific medications, procedures, or treatments
- Duration anticipated for the condition
- Your viewpoint or choice
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Unfortunately, there is no cure for renal illness. The focus of treatment is on decreasing the disease’s course and preventing consequences. The treatment may involve:
- Blood pressure medications, such as ACE (angiotensin-converting enzyme) inhibitors, which safeguard kidney blood flow.
- Corticosteroids may be administered to reduce inflammation that results in scar tissue formation.
- Diuretics (water tablets) may be used to rid the body of excess fluid by increasing urine production.
- Dietary modifications consisting of consuming less protein, salt, and potassium
- Dialysis to remove toxins and fluid from the circulation when the kidneys are no longer functioning.
- Kidney transplant involving the replacement of a sick kidney with a healthy donor kidney.
Prevention
There is no proven method to avoid glomerulonephritis, but the following activities may be beneficial:
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- Consume wholesome, unprocessed foods.
- Treat hypertension with a low-sodium diet, physical activity, and medication.
- Prevent infections through basic hygiene and safe sexual behavior. Additionally, avoid using needles for illegal substances and tattoos.
- Consult a physician if you suspect you have an illness such as strep throat.
Complications
GN can develop to nephrotic syndrome, which causes significant protein loss in the urine. This causes significant fluid and salt retention in the body. You can acquire high blood pressure, elevated cholesterol, and bodily edema. This disorder is treated with corticosteroids. Nephrotic syndrome will eventually progress to end-stage renal disease if it is not controlled.
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Additionally, the following conditions may result from GN:
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- Acute kidney failure
- End-stage renal disease
- Electrolyte abnormalities, including excessive sodium or potassium levels
- Persistent urinary tract infection
- Congestive heart failure resulting from fluid retention or fluid overload
- Pulmonary edema caused by fluid retention or fluid excess
- Elevated blood pressure
- Malignant hypertension, which is high blood pressure with a rapid increase
- Increased infection risk
