Glomerulonephritis- causes, symptoms, diagnosis and treatments

What is Glomerulonephritis?

Definition: Glomerulonephritis (GN) is an inflammatory condition affecting the glomeruli, the tiny filtering units within the kidneys. These filters are essential for removing waste products, excess fluids, and electrolytes from the blood to produce urine. When the glomeruli become inflamed and scarred, their ability to perform this function deteriorates, leading to a buildup of waste and fluid in the body.

What are the Causes of glomerulonephritis?

1. Infections:
   • Viral Infections: Certain viruses can trigger GN. Notable examples include HIV, hepatitis B, and hepatitis C.
   • Bacterial Infections: Bacteria that cause common throat and skin infections, such as Streptococcus spp or Staphylococcus spp
2. Autoimmune Diseases:
   • Lupus: Systemic lupus erythematosus (SLE) can lead to kidney inflammation as part of a broader autoimmune response.
   • IgA Nephropathy (Berger Disease): This condition involves the buildup of immunoglobulin A (IgA) in the glomeruli, causing inflammation and damage.
3. Genetic Conditions:
   • Alport Syndrome: An inherited disorder that not only causes kidney disease but also affects hearing and vision.
4. Toxins and Medications:
   • Certain drugs or exposure to toxins can damage the glomeruli and trigger GN.

What are the symptoms of glomerulonephtitis?

• Early Symptoms: Often, the kidneys may be significantly damaged before symptoms become apparent. Common early symptoms include:
  • Fatigue: Persistent tiredness that can be a sign of kidney dysfunction.
  • High Blood Pressure: Elevated blood pressure often accompanies GN.
  • Swelling: Accumulation of fluid leading to swelling in the face, hands, feet, and abdomen.
  • Blood and Protein in Urine: Known as hematuria and proteinuria, respectively. These indicators can be detected through urine tests.
• Progressive Symptoms:
  • Decreased Urine Output: Reduced production of urine may signal worsening kidney function.
  • Nausea and Vomiting: These symptoms can occur due to toxin buildup in the body.
  • Fever and Flu-like Symptoms: Systemic inflammation can cause these general symptoms.

How to diagnosis glomerulonephritis?

1. Medical History and Physical Exam: Initial assessment to understand symptoms and possible underlying conditions.
2. Urinalysis: Examines urine for the presence of red and white blood cells, protein, and signs of infection.
3. Blood Tests: Measures levels of waste products like creatinine and urea to evaluate how well the kidneys are filtering blood.
4. Ultrasound: Uses high-frequency sound waves to create images of the kidneys. It helps to assess kidney size, shape, and blood flow, and to identify any abnormalities or blockages.
5. Kidney Biopsy: A definitive diagnostic procedure where a small tissue sample is removed from the kidney and examined under a microscope to detect inflammation, scarring, and other pathological changes.

How to treat glomerulonephritis?

1. Management of Mild Cases:
   • Monitoring: Regular follow-ups to track kidney function and symptoms.
   • Lifestyle Adjustments: Includes dietary changes to reduce salt, protein, and potassium intake.
2. Treatment for Severe Cases:
   • Medications:
     • Blood Pressure Medicines: ACE (angiotensin-converting enzyme) inhibitors help protect kidney function by managing blood pressure.
     • Corticosteroids: These drugs reduce inflammation and prevent scarring of the glomeruli.
     • Diuretics: Help to manage fluid retention by increasing urine production.
   • Dietary Modifications: Limiting protein, sodium, and potassium to reduce kidney strain.
   • Advanced Treatments:
     • Dialysis: An external process that filters blood when the kidneys can no longer perform this function.
     • Kidney Transplant: Replaces the diseased kidney with a healthy kidney from a donor, often considered when kidney function declines to end-stage renal disease (ESRD).

What are the main complications of glomerulonephritis?

• Kidney Failure: Progressive GN can lead to kidney failure, requiring dialysis or a transplant.
• High Blood Pressure: Persistent elevated blood pressure may develop or worsen.
• High Cholesterol: Elevated cholesterol levels are common in chronic kidney conditions.
• Blood Clots: Increased risk of clots such as deep vein thrombosis (DVT) or pulmonary embolism.
• Damage to Other Organs: Prolonged GN can affect other body systems.

When to Contact a Healthcare Provider:

• Seek medical advice if symptoms worsen, new symptoms develop, or if there are concerns about kidney function.

Key Points:

Glomerulonephritis is an inflammatory disease of the kidneys’ filtering units, leading to impaired waste removal and potential complications. Early diagnosis and treatment are crucial for managing symptoms, preventing progression, and addressing potential kidney failure. Regular monitoring and treatment adjustments can significantly impact the management of this condition.