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Glomerulonephritis

Overview

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Glomerulonephritis is a group of kidney disorders characterized by inflammation of the glomeruli, which are the tiny filtering units in the kidneys. This inflammation impairs the kidneys' ability to filter waste and excess fluids from the blood effectively, leading to various health issues. Glomerulonephritis can be acute (developing suddenly) or chronic (progressing slowly over time).

This inflammation impairs the kidneys' ability to filter waste and excess fluids from the blood effectively, leading to various health issues. Glomerulonephritis can be acute (developing suddenly) or chronic (progressing slowly over time).

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Symptoms
  • Hematuria: Blood in the urine, which can make the urine appear pink, red, or brown.
  • Proteinuria: Excess protein in the urine, leading to foamy urine.
  • Edema: Swelling in areas like the face, hands, feet, and ankles due to fluid retention.
  • Hypertension: Elevated blood pressure.
  • Oliguria: Reduced urine output.
  • Fatigue: General feeling of tiredness or weakness.
  • Shortness of Breath: Due to fluid accumulation in the lungs or elsewhere.
  • Abdominal Pain: Particularly in the lower back or sides.
Complications
  • Chronic Kidney Disease (CKD): Prolonged inflammation can lead to progressive loss of kidney function.
  • Kidney Failure: Severe cases may result in end-stage renal disease requiring dialysis or transplantation.
  • High Blood Pressure: Persistent hypertension can further damage the kidneys.
  • Fluid Overload: Can lead to complications such as heart failure or pulmonary edema.
  • Electrolyte Imbalance: Disruption in balance of potassium, sodium, and other electrolytes.
Causes
  • Infections: Such as post-streptococcal glomerulonephritis following a streptococcal infection (e.g., strep throat).
  • Autoimmune Diseases: Conditions like systemic lupus erythematosus (SLE) or IgA nephropathy.
  • Vasculitis: Inflammation of the blood vessels affecting the kidneys.
  • Genetic Disorders: Conditions such as Alport syndrome or familial glomerulonephritis.
  • Drug-Induced: Reactions to certain medications or toxins.
  • Conditions Leading to Systemic Inflammation: Such as diabetic nephropathy or hypertension.
Prevention
  • Manage Chronic Conditions: Control blood pressure and diabetes effectively to reduce the risk of kidney damage.
  • Prompt Treatment of Infections: Early treatment of infections to prevent post-infectious glomerulonephritis.
  • Avoiding Nephrotoxins: Minimize exposure to drugs and substances that can harm the kidneys.
  • Regular Check-ups: Monitoring kidney function if at risk due to conditions or family history.
  • Healthy Lifestyle: Maintaining a balanced diet, staying hydrated, and avoiding excessive salt intake.
Risk Factors
  • Family History: Genetic predisposition to kidney diseases.
  • Existing Health Conditions: Diabetes, hypertension, or autoimmune diseases.
  • Infections: Recent history of infections, particularly streptococcal infections.
  • Age and Gender: Some forms of glomerulonephritis may be more common in specific age groups or genders.
  • Use of Certain Medications: Long-term use of drugs that can affect kidney function.
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How is it treated?

Medications:

  • Corticosteroids: To reduce inflammation (e.g., prednisone).
  • Immunosuppressants: For autoimmune-related glomerulonephritis (e.g., cyclophosphamide, azathioprine).
  • Antihypertensives: To manage high blood pressure and protect kidney function (e.g., ACE inhibitors, ARBs).
  • Diuretics: To reduce fluid retention and swelling.

Lifestyle Changes:

  • Dietary Modifications: Low-sodium, low-protein diets to reduce kidney strain.
  • Fluid Management: Monitoring fluid intake and output to prevent overload.
  • Regular Monitoring: Frequent assessments of kidney function and blood pressure.

Treatment of Underlying Causes:

  • Antibiotics: For treating infections.
  • Management of Autoimmune Conditions: Tailored treatment based on specific autoimmune diseases.
  • Dialysis: In cases of severe kidney impairment or failure, dialysis may be required to perform the kidney’s filtering function.
  • Kidney Transplant: Considered for end-stage renal disease, where a healthy kidney from a donor replaces the damaged ones.
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How is it Diagnosed?

Glomerulonephritis is diagnosed through a combination of clinical evaluation, urine tests, blood tests, and kidney imaging or biopsy. Patients may present with symptoms like hematuria (blood in urine), proteinuria, edema, and hypertension.

Urinalysis typically reveals red blood cell casts, protein, and white blood cells, indicating glomerular inflammation. Blood tests assess kidney function via creatinine and blood urea nitrogen (BUN) levels and may show reduced glomerular filtration rate (GFR). Tests for antibodies such as anti-streptolysin O (ASO), antinuclear antibodies (ANA), or antineutrophil cytoplasmic antibodies (ANCA) help identify underlying causes, including autoimmune or post-infectious origins.

Complement levels (C3, C4) can be abnormal depending on the subtype. Ultrasound of the kidneys assesses size and structural abnormalities. The definitive diagnosis often requires a renal biopsy, which helps determine the extent and type of glomerular damage, guiding prognosis and treatment.

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FAQs

  • Yes, if left untreated or if severe, Glomerulonephritis can lead to chronic kidney disease and eventual kidney failure.

  • The reversibility depends on the cause and severity. Some cases, especially those linked to infections, can improve with treatment, while chronic forms may lead to permanent damage.

While not all cases are preventable, you can reduce risk by:

  • Managing chronic conditions like diabetes and hypertension.
  • Practicing good hygiene to prevent infections.
  • Seeking timely treatment for any infections.

  • The outlook varies widely based on the cause and severity. Some individuals recover fully, while others may experience chronic issues or require dialysis.

  • Seek medical attention if you experience symptoms like changes in urine color, swelling, high blood pressure, or persistent fatigue. Early diagnosis and treatment are essential for better outcomes.
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