Glomerulonephritis
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Definition
Glomerulonephritis is a kidney condition that involves damage to the glomeruli. Glomeruli are the tiny structures within the kidney that filter blood.

The kidneys are bean-shaped organs located in the back just below the rib cage. Each kidney is about the size of a fist. The two kidneys filter blood, catch needed substances and return them to the circulation, and dispose of wastes in the urine. If the kidneys don’t filter properly, wastes build up in the blood.

There are two types of glomerulonephritis:

  • Acute glomerulonephritis begins suddenly.
  • Chronic glomerulonephritis develops gradually over several years.
In some cases, glomerulonephritis leads to kidney failure. Kidney failure is a severe kidney disease that must be treated with dialysis or kidney transplant.

Anatomy of the Kidney

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Causes
Causes of glomerulonephritis include:

Risk Factors
Factors that increase your chances of getting glomerulonephritis include:

  • Family history of glomerulonephritis
  • The presence of a known cause of glomerulonephritis
  • Exposure to a cause
  • High blood pressure
Symptoms
Glomerulonephritis sometimes causes no symptoms and is discovered during a routine urine test. When present, the symptoms of acute and chronic glomerulonephritis differ from one another.

The symptoms of acute glomerulonephritis may include:

  • Blood in urine
  • Foamy appearance of urine
  • Less frequent urination
  • Swelling in the morning, especially in the face, feet, hands, and abdomen
Chronic glomerulonephritis can lead to kidney failure. It may cause these symptoms:

  • Feeling tired
  • Dry, itchy skin
  • Nausea and vomiting
  • Poor appetite
  • Muscle cramps at night
  • Swelling of the face, feet, hands, or abdomen
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a nephrologist who specializes in kidney disease for further diagnostic testing and treatment.

Your bodily fluids and tissues may be tested. This can be done with:

  • Urinalysis
  • Blood tests
  • Kidney biopsy
Images may be taken of your bodily structures. This can be done with:

Treatment
Treatment will depend on the cause of glomerulonephritis. The following steps may be taken to help kidney function or reduce further damage:

Medications
  • Diuretics to reduce fluid retention
  • Medications to suppress the immune system such as steroids
  • ACE inhibitors to control blood pressure and protein excretion
Lifestyle Changes
  • Restrict salt and water intake.
  • Restrict intake of potassium, phosphorous, and magnesium.
  • Cut down on protein in the diet.
  • Maintain a healthy weight through diet and exercise.
  • Take calcium supplements.
Dialysis and Transplant
If the kidneys are unable to remove sufficient waste from the blood, dialysis may be required. Temporary dialysis may be sufficient for acute glomerulonephritis. If it leads to permanent kidney failure, chronic glomerulonephritis will require long-term dialysis or kidney transplant.

Prevention
The following steps may decrease your risk of glomerulonephritis:

  • See a doctor promptly if you have a sore throat that might be due to strep.
  • To reduce the risk of getting viral infections, including HIV, use safe sex practices and avoid intravenous drug use.
  • If you have diabetes or high blood pressure, see your doctor about managing these conditions.



RESOURCES:
National Kidney Foundation

National Kidney and Urologic Diseases Information Clearinghouse

CANADIAN RESOURCES:

The Kidney Foundation of Canada

References:
Glomerulonephritis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 1, 2010. Accessed July 12, 2013.

Glomerulonephritis. National Kidney Foundation website. Available at: http://www.kidney.org/atoz/content/glomerul.cfm. Accessed July 12, 2013.

Last Reviewed July 2013



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