Glomerulonephritis (GLOM-er-oo-loh-nef-RYE-tis) refers to a group of diseases that damage the filtering ability of the kidneys in a way that prevents the body from getting rid of metabolic wastes and excess water.
Imani will always remember fifth grade because she missed so much of it. She missed one week of school because she had strep throat, a sore throat caused by streptococcal bacteria. Several weeks later, Imani felt very tired, she lost her appetite, her abdomen and back hurt, and her face looked puffy. She rarely had to urinate, and when she did, her urine * was a dark color like cola. Imani's doctor suspected that she had a case of acute * (sudden) glomerulonephritis that was a complication of her strep throat. Her doctor explained that Imani's kidneys were not working properly and that waste products from the cells were building up inside her body. Imani's condition got worse. She spent several days in the hospital, and then she recuperated at home for several weeks.
Each kidney is made up of about one million units called nephrons (NEF-rons). Each nephron consists of a collecting tubule that eventually takes wastes to the bladder and a filtering unit called a glomerulus * .
In a person with glomerulonephritis, the glomeruli (plural of glomerulus) do not function properly. When the glomeruli are damaged, the filtering mechanism does not work properly. Instead of keeping proteins in the blood, while allowing excess water, ions * , and wastes to pass through the filter into collecting tubules where they become urine, the glomeruli filters leak. This leakage allows proteins to move out of the bloodstream with the water and wastes and to be excreted in the urine. Loss of large amounts of protein from the blood then causes fluid to leak out of the bloodstream into the body's tissues. The retention of fluid gives the body, especially the face and legs, a puffy and bloated appearance.
Although there are many causes of glomerulonephritis, scientists think that they are all related to a problem caused by immune system * proteins called immunoglobulins. Some event that is not completely understood stimulates these proteins to collect in glomerular cells. This causes inflammation * in cells that results in damage to the glomeruli.
Symptoms of acute glomerulonephritis include blood in the urine, which turns it a brownish color, a decreased volume of urine, and puffiness in the face and ankles from fluid retention. Eventually fluid may accumulate in the lungs making breathing difficult. Blood and urine tests are done to determine the extent of the kidney damage.
In treating acute glomerulonephritis, the physician corrects any chemical imbalances in the blood caused by loss of proteins and other molecules in the urine. Diuretic drugs are used to help eliminate excess fluid from the body. Antibiotics and corticosteroid * drugs are given to control infection and inflammation. In serious cases, dialysis may be temporarily necessary to remove waste products that have built up in the blood. Most people recover completely from acute glomerulonephritis, but in about 10 percent of people, the condition becomes chronic * .
Chronic glomerulonephritis may develop without symptoms for many years. The disease can be triggered by or associated with many diseases and conditions, including the autoimmune diseases systemic lupus * erythematosus, HIV * /AIDS * infection, and Goodpasture's syndrome * (a rare condition). Chronic glomerulonephritis also can develop from diabetes * and severe high blood pressure (hypertension).
Symptoms of chronic glomerulonephritis often go unrecognized for a long time and include protein in the urine, foamy urine, high blood pressure, swelling in the face and ankles, and frequent urination. Often the first indication of chronic glomerulonephritis comes from an abnormal urinalysis during a routine physical examination. As kidney failure progresses, fatigue, nausea and vomiting, difficulty sleeping, and nighttime muscle cramps develop.
Diagnostic blood, urine, and imaging tests are done to determine the underlying cause of the disease and to assess how far kidney failure has progressed. A kidney biopsy * is sometimes performed.
Chronic glomerulonephritis cannot be cured, but it can be treated. If an underlying disease such as diabetes or lupus is causing the kidney damage, that disease is treated. Chronic glomerulonephritis tends to worsen with time, eventually ending in complete kidney failure. When the kidneys fail, people either need kidney dialysis several times per week or a kidney transplant in order to survive.
See also Diabetes • Kidney Disease
Charnow, Jody, A. “Chronic Kidney Disease Raises Fracture Risk in Children.” Renal and Urology News, July 14, 2015. http://www.renalandurologynews.com/chronic-kidney-disease-ckd/chronickidney-disease-raises-fracture-risk-in-children/article/425991/ (accessed October 21, 2015).
National Kidney and Urologic Diseases Information Clearinghouse. “Glomerular Diseases.” National Institutes of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/glomerular/index.htm (accessed October 21, 2015).
Nephron Information Center. Website: http://nephron.org (accessed October 21, 2015).
National Kidney Foundation. 30 E 33rd St., New York, NY 10016. Toll-free: 800-622-9010. Website: http://www.kidney.org (accessed October 21, 2015).
* urine is the liquid waste material secreted by the kidneys and removed from the body through the urinary tract.
* acute describes an infection or other illness that comes on suddenly and usually does not last very long.
* glomerulus (glom-ER-you-lus) is from a Greek word meaning filter. The glomerulus is a knot of blood vessels that have the job of filtering the blood.
* ions are positively or negatively charged elements or compounds, such as hydrogen, sodium, potassium, and phosphate, which are necessary for cellular metabolism.
* immune system (im-YOON SIS-tem) is the system of the body composed of specialized cells and the substances they produce that helps protect the body against disease-causing germs.
* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.
* endocarditis (en-do-kar-DYE-tis) is an inflammation of the valves and internal lining of the heart, known as the endocardium (en-doh-KAR-dee-um), usually caused by an infection.
* corticosteroid (KOR-ti-ko-STERoid) is one of several medications that are prescribed to reduce inflammation and sometimes to suppress the body's immune response.
* chronic (KRAH-nik) means lasting a long time or recurring frequently.
* lupus (LOO-pus) is a chronic, or long-lasting, disease that causes inflammation of connective tissue, the material that holds together the various structures of the body.
* HIV or human immunodeficiency virus (HYOO-mun ih-myoono-dih-FIH-shen-see) is the virus that causes AIDS (acquired immunodeficiency syndrome).
* AIDS or acquired immunodeficiency (ih-myoo-no-dih-FIH-shensee) syndrome is an infection that severely weakens the immune system; it is caused by the human immunodeficiency virus (HIV).
* Goodpasture's syndrome is an autoimmune disorder of unknown cause, characterized by circulating antibodies in the blood that attack the membrane of the kidney's glomeruli and the lung's alveoli.
* diabetes (dye-uh-BEE-teez) is a condition in which the body's pancreas does not produce enough insulin or the body cannot use the insulin it makes effectively, resulting in increased levels of sugar in the blood. This can lead to increased urination, dehydration, weight loss, weakness, and a number of other symptoms and complications related to chemical imbalances within the body.
* biopsy (BI-op-see) is a test in which a small sample of skin or other body tissue is removed and examined for signs of disease.