Glomerulonephritis


  • The kidney is made of multiple structures that are involved in filtering the blood in order to remove waste products and maintain fluid/electrolyte balance.  The glomerulus (tuft or cluster composed of blood vessels and nerve fibers) is one of the primary filtering structures.  When the glomerulus becomes inflamed, this is known as Glomerulonephritis.  There are numerous causes.
  • Glomerulonephritis syndromes can be divided into three categories based on symptoms and signs, as follows:
    1. Nephritic syndrome -- High Blood Pressure, leg swelling, and urine analysis shows red blood cells, red blood cell casts, and moderate amounts of protein.
    2. Nephrotic Syndrome -- often-massive leg and body swelling, blood has elevated triglycerides (fats), and urine shows large amounts of protein.
    3. Disease states that affect the kidney -- for example, Systemic Lupus Erythematosus -- is an arthritic condition that frequently affects the kidneys (multi-system diseases, i.e., they affect more than one organ in the body).
  • Nephritic conditions include:
    1. Poststreptococcal Glomerulonephritis -- occurs after a throat or Skin Infection of strep bacteria
    2. IgA Nephropathy (Berger's disease) -- an autoimmune disease in which the body attacks the kidneys
    3. Henoch-Schonlein purpura -- (probably) an autoimmune disease that also has raised red skin lesions on the legs
    4. Rapidly progressive Glomerulonephritis -- this is a general category of sudden rapid inflammation of the glomeruli of the kidney. It can lead to rapid kidney failure and needs early aggressive treatment
    5. Crescentic Glomerulonephritis -- may be idiopathic (unknown cause) or be part of another disease process going on in the body (Wegener's Granulomatosis)
    6. Goodpasture's syndrome -- kidney disease of the membrane of the glomeruli that is associated with bleeding in the lung as well.
    1. Minimal change disease -- most commonly seen in children.
    2. Focal glomerulosclerosis -- commonly seen in AIDS
    3. Membranous Glomerulonephritis -- the most common form in adults.  The cause may be unknown, but also may be associated with other diseases, such as Hepatitis B, Systemic Lupus Erythematosus, or thyroid disease (plus others)
    4. Membranoproliferative Glomerulonephritis
  • Multisystem diseases:
    1. Systemic Lupus Erythematosus -- an arthritic condition that can affect many other organs, including the kidneys and lungs
    2. Diabetic nephropathy
    3. Multiple Myeloma -- a type of cancer of cells in the bone marrow

  • Urinalysis
  • 24-hour urine collection to check protein and Creatinine clearance (kidney function)
  • Blood tests -- kidney function (BUN, Creatinine), Electrolytes, tests for specific disease states (e.g., ANA for lupus, anti-GBM for Goodpasture's disease, ANCA level for Wegener's disease)
  • A kidney biopsy often with special staining techniques (kidney biopsies usually can be done by needle biopsy, without surgery)
  • Kidney Ultrasound may be performed

  • Depends on the cause.  For autoimmune causes (i.e., the majority of the collective cases), corticosteroids and/or immune suppressant agents are used.  For other causes, the underlying condition is treated.  A Kidney specialist (nephrologist) decides the actual course of treatment.

  • You need immediate medical treatment.  Delay can result in permanent kidney damage or death.