Glomerulonephritis (GN): Symptoms, Causes, Treatment

What are the symptoms of glomerulonephritis?

Glomerulonephritis, also known as glomerular nephritis, is a group of diseases that affect the part of the kidney that filters blood (the glomeruli). The symptoms can vary depending on the type and severity of the condition, but common symptoms include:

1. Blood in the urine (hematuria), which may make the urine pink, red, or cola-colored
2. Foamy urine, due to excess protein in the urine (proteinuria)
3. Swelling (edema) in the face, hands, feet, and abdomen, often noticed in the morning
4. High blood pressure
5. Reduced urine output
6. Fatigue
7. Shortness of breath
8. Headaches
9. Nausea and vomiting

In chronic or severe cases, glomerulonephritis can lead to kidney failure, which may cause additional symptoms like itching, muscle cramps, and loss of appetite. It’s important to see a healthcare provider for an accurate diagnosis and appropriate management if you suspect you have glomerulonephritis.

What are the causes of glomerulonephritis?

Glomerulonephritis can have several causes, including:

1. Infections: These can be bacterial (such as streptococcal infections, which can lead to post-streptococcal glomerulonephritis), viral (such as hepatitis B and C, HIV, and COVID-19), or parasitic (such as malaria).
2. Immune diseases: Conditions like lupus (systemic lupus erythematosus) and IgA nephropathy involve the immune system mistakenly attacking the glomeruli.
3. Vasculitis: Inflammation of blood vessels, such as in granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis) and microscopic polyangiitis, can affect the kidneys.
4. Diabetes: Uncontrolled diabetes can damage the kidneys over time, leading to diabetic nephropathy, a form of glomerulonephritis.
5. Hypertension: Chronic high blood pressure can strain the glomeruli, leading to kidney damage.
6. Exposure to toxins: Certain medications, toxins, and heavy metals can cause glomerular damage.
7. Genetic factors: Some forms of glomerulonephritis have a genetic component.
8. Idiopathic: In many cases, the cause of glomerulonephritis is unknown (idiopathic).

It’s important to determine the specific cause of glomerulonephritis to guide treatment and management. This often involves a combination of medical history, physical examination, blood tests, urine tests, imaging studies, and sometimes a kidney biopsy.

How is the diagnosis of glomerulonephritis made?

The diagnosis of glomerulonephritis typically involves several steps, including:

1. Medical history and physical examination: Your healthcare provider will ask about your symptoms, medical history, and any risk factors you may have for glomerulonephritis. They will also perform a physical examination to look for signs of kidney damage, such as swelling (edema) and high blood pressure.
2. Laboratory tests: Blood tests can help evaluate kidney function (e.g., creatinine and blood urea nitrogen) and assess for signs of inflammation or infection. Urine tests can detect the presence of blood and protein in the urine, which are common signs of glomerulonephritis.
3. Imaging studies: Imaging tests such as ultrasound, CT scan, or MRI may be used to assess the size and structure of the kidneys and detect any abnormalities.
4. Kidney biopsy: A kidney biopsy may be recommended to confirm the diagnosis and determine the specific type of glomerulonephritis. During a biopsy, a small sample of kidney tissue is removed and examined under a microscope.
5. Other tests: Depending on the suspected cause of glomerulonephritis, additional tests may be performed. For example, tests for autoimmune diseases (e.g., antinuclear antibodies) or infections (e.g., hepatitis B and C, HIV) may be done.

What is the treatment for glomerulonephritis?

The treatment for glomerulonephritis (GN) depends on the underlying cause, severity, and progression of the disease. Here are some common treatment options:

1. Corticosteroids: Steroids, such as prednisone, can help reduce inflammation and slow the progression of GN.
2. Immunosuppressive medications: Medications like cyclophosphamide, azathioprine, and mycophenolate mofetil can help suppress the immune system and prevent further damage to the kidneys.
3. Plasmapheresis: This procedure removes abnormal proteins and antibodies from the blood to reduce inflammation and slow disease progression.
4. Dialysis: If kidney function declines significantly, dialysis may be necessary to remove waste products from the blood.
5. Kidney transplantation: In severe cases, kidney transplantation may be considered as a treatment option.
6. Antihypertensive medications: Medications like ACE inhibitors or ARBs can help control high blood pressure, which can exacerbate GN.
7. Blood pressure monitoring: Regular monitoring of blood pressure is crucial to prevent complications.
8. Fluid and electrolyte management: Patients with GN may need to restrict fluid intake and monitor electrolyte levels to prevent complications like fluid overload or electrolyte imbalance.
9. Antibiotics: If an infection is suspected or confirmed, antibiotics may be prescribed to treat the underlying infection.
10. Rituximab: This medication can help reduce inflammation and prevent further damage in some cases of GN.

Specific treatment regimens may vary depending on the underlying cause of GN, such as:

• Lupus nephritis: Corticosteroids, immunosuppressive medications, and rituximab may be used in combination with each other.
• Post-infectious glomerulonephritis: Antibiotics are used to treat the underlying infection, while corticosteroids and immunosuppressive medications may be used to reduce inflammation.
• Idiopathic membranous glomerulonephritis: Corticosteroids and immunosuppressive medications may be used to reduce inflammation.

It’s essential for individuals with GN to work closely with their healthcare provider to develop a personalized treatment plan that addresses their specific needs and health status.

What age does glomerulonephritis start?

Glomerulonephritis can occur at any age, but it is more common in certain age groups. Here are some age-specific patterns:

1. Children: Glomerulonephritis can occur in children, particularly in those with underlying conditions such as:
   • Post-streptococcal glomerulonephritis (PSGN): usually occurs in children under 16 years old, often after a streptococcal infection.
   • IgA nephropathy: can occur in children and adolescents, typically between 5-15 years old.
2. Young adults: Glomerulonephritis can also occur in young adults, often due to:
   • Lupus nephritis: can occur in individuals of any age, but is more common in women between 15-40 years old.
   • Membranous glomerulonephritis: can occur in young adults, often between 20-40 years old.
3. Adults: Glomerulonephritis can affect adults of all ages, with the peak incidence occurring in:
   • Middle-aged adults (40-60 years old): often due to underlying conditions like hypertension, diabetes, or lupus.
   • Older adults (60+ years old): may be more susceptible to glomerulonephritis due to age-related changes in the kidneys and underlying medical conditions.

It’s essential to note that glomerulonephritis can occur at any age, and it’s not uncommon for individuals to develop the condition later in life. If you experience symptoms like blood in your urine, swelling, or high blood pressure, it’s crucial to consult with a healthcare provider for proper evaluation and treatment.