Glomerulonephritis

Glomerulonephritis is the damage and inflammation of the small blood vessels responsible for filtering blood in the kidneys (glomeruli). Structural changes in the glomeruli impair their proper function, preventing waste products from being adequately eliminated and affecting the body as a whole.

There are two types of glomerulonephritis:

• Primary glomerulonephritis: the disease originates in the kidney, which is the only affected organ.
  • Membranous nephropathy: the walls of the glomeruli become thickened.
  • IgA nephropathy or Berger disease: a type of autoimmune glomerulonephritis characterized by the formation of immunoglobulin A (IgA) deposits in the renal capillaries.
  • Focal segmental glomerulosclerosis: scarring develops in the glomerular tissue.
  • Minimal change disease: damage to the glomeruli is minimal, making it difficult to detect. It causes protein accumulation in the urine.
• Secondary glomerulonephritis: occurs as a consequence of another disease or the use of certain medications.
  • Lupus nephritis: develops when systemic lupus erythematosus damages the internal structures of the kidneys.
  • Immune complex glomerulonephritis: the glomeruli become inflamed due to an abnormal accumulation of antigen-antibody complexes in the kidneys, usually as a result of an autoimmune disease.
  • Post-infectious glomerulonephritis: although it may occur following any type of infection, it is most commonly caused by a streptococcal bacterial infection.
  • Rapidly progressive glomerulonephritis (RPGN): a nephritic syndrome that progresses over a few days and leads to kidney failure.

The prognosis of glomerulonephritis depends on the type of disease and the extent of damage caused. In mild cases diagnosed early, the condition may be reversed without permanent kidney damage. However, when the disease is severe or does not respond adequately to treatment, it may progress to kidney failure.

Symptoms

The most characteristic symptoms of glomerulonephritis are:

• Hematuria: presence of blood in the urine, causing it to appear brown, pink, or red.
• Proteinuria: accumulation of protein in the urine. This often causes foamy urine.
• Oliguria: lower-than-normal urine output.
• Anuria: very little urine production or no urine output at all.
• Hypertension.
• Edema (swelling) in the legs, hands, or face as a result of fluid retention.
• Muscle cramps.
• Pallor.
• Fatigue.
• Headache.
• Abdominal pain.
• Shortness of breath resulting from excess fluid accumulation in the body.

Glomerulonephritis is classified into two types according to the way symptoms present:

• Acute glomerulonephritis: symptoms appear suddenly, usually after an infection. The first signs are typically hypertension, edema, and hematuria.
• Chronic glomerulonephritis: develops gradually without symptoms for months or even years. By the time it is detected, signs of kidney failure are often already present.

Causes

The most common causes of glomerulonephritis are:

• Streptococcal infections, usually affecting the throat.
• Viral kidney infection.
• Bacterial endocarditis, an infection of the tissue lining the chambers and valves of the heart.
• HIV.
• Lupus.
• IgA nephropathy.
• Goodpasture syndrome: the immune system produces antibodies against tissues in the kidneys and lungs.
• Vasculitis, which is inflammation of the blood vessels.
• Hypertension.
• Diabetes, which may lead to diabetic nephropathy.
• Focal segmental glomerulosclerosis.
• In rare cases, lung or stomach cancer.
• Certain types of leukemia.

Risk Factors

The main risk factors for glomerulonephritis are the diseases described above.

Complications

Glomerulonephritis may lead to the following conditions:

• Acute or chronic kidney damage.
• Nephrotic syndrome: increased permeability of the glomeruli.
• Kidney failure: the kidneys do not adequately filter waste products carried in the blood.
• Heart failure: excess fluid in the body causes the heart to work harder.
• Pulmonary edema: accumulation of fluid in the lungs.
• Hyperkalemia: elevated potassium levels in the blood due to an electrolyte imbalance.
• Loss of red blood cells.

Prevention

Although glomerulonephritis cannot be prevented, maintaining good health may help reduce the risk of developing it. In particular:

• Treat infections according to medical recommendations.
• Practice safe sex.
• Monitor blood pressure.
• Control blood glucose levels.
• Do not smoke.
• Limit alcohol consumption.
• Follow a healthy diet.
• Exercise regularly.

Which specialist treats Glomerulonephritis?

Glomerulonephritis is treated within the specialty of Nephrology.