What is glomerulonephritis? Glomerulonephritis (GN) is inflammation of the glomeruli, which are structures in your kidneys that are made up of tiny blood vessels. These knots of vessels help filter your blood and remove excess fluids. If your glomeruli are damaged, your kidneys will stop working properly, and you can go into kidney failure. Sometimes called nephritis, GN is a serious illness that can be life-threatening and requires immediate treatment. GN can be both acute, or sudden, and chronic, or long-term. This condition used to be known as Bright’s disease. Read on to learn what causes GN, how it’s diagnosed, and what the treatment options are.

What are the causes of GN? The causes of GN depend on whether it’s acute or chronic. Acute GN Acute GN can be a response to an infection such as strep throat or an abscessed tooth. It may be due to problems with your immune system overreacting to the infection. This can go away without treatment. If it doesn’t go away, prompt treatment is necessary to prevent long-term damage to your kidneys. Certain illnesses are known to trigger acute GN, including: strep throat

systemic lupus erythematosus, which is also called lupus

Goodpasture syndrome, a rare autoimmune disease in which antibodies attack your kidneys and lungs

amyloidosis, which occurs when abnormal proteins that can cause harm build up in your organs and tissues

granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis), a rare disease that causes inflammation of the blood vessels

polyarteritis nodosa, a disease in which cells attack arteries Heavy use of nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil) and naproxen (Aleve), may also be a risk factor. You shouldn’t exceed the dosage and length of treatment listed on the bottle without seeking advice from your primary care provider. Chronic GN The chronic form of GN can develop over several years with no or very few symptoms. This can cause irreversible damage to your kidneys and ultimately lead to complete kidney failure. Chronic GN doesn’t always have a clear cause. A genetic disease can sometimes cause chronic GN. Hereditary nephritis occurs in young men with poor vision and poor hearing. Other possible causes include: certain immune diseases

a history of cancer

exposure to some hydrocarbon solvents As well, having the acute form of GN may make you more likely to develop chronic GN later on.

How is GN diagnosed? The first step in diagnosis is a urinalysis test. Blood and protein in urine are important markers for the disease. A routine physical exam for another condition can also lead to the discovery of GN. More urine testing may be necessary to check for important signs of kidney health, including: creatinine clearance

total protein in the urine

urine concentration

urine specific gravity

urine red blood cells

urine osmolality Blood tests may show: anemia, which is a low level of red blood cells

abnormal albumin levels

abnormal blood urea nitrogen

high creatinine levels Your doctor may also order immunology testing to check for: antiglomerular basement membrane antibodies

antineutrophil cytoplasmic antibodies

antinuclear antibodies

complement levels Results of this testing may show your immune system is damaging your kidneys. A biopsy of your kidneys may be necessary to confirm the diagnosis. This involves analyzing a small sample of kidney tissue taken by a needle. To learn more about your condition, you may also have imaging tests such as the following: CT scan

kidney ultrasound

chest X-ray

intravenous pyelogram

What treatments are available for GN? Treatment options depend on the type of GN you’re experiencing and its cause. One treatment is to control high blood pressure, especially if that’s the underlying cause of the GN. Blood pressure may be very hard to control when your kidneys aren’t working properly. If this is the case, your doctor may prescribe blood pressure medications, including angiotensin-converting enzyme inhibitors, or ACE inhibitors, such as: captopril

lisinopril (Zestril)

perindopril (Aceon) Your doctor may also prescribe angiotensin receptor blockers, or ARBs, such as: losartan (Cozaar)

irbesartan (Avapro)

valsartan (Diovan) Corticosteroids may also be used if your immune system is attacking your kidneys. They reduce the immune response. Another method to reduce immune-triggered inflammation is plasmapheresis. This process removes the fluid part of your blood, called plasma, and replaces it with intravenous fluids or donated plasma that contains no antibodies. For chronic GN, you’ll need to reduce the amount of protein, salt, and potassium in your diet. Additionally, you must watch how much liquid you drink. Calcium supplements may be recommended, and you may need to take diuretics to reduce swelling. Check with your general practitioner or kidney specialist for guidelines about diet restrictions or supplements. They can set you up with a medical dietician to advise you on your choices. If your condition becomes advanced and you develop kidney failure, you may need to have dialysis. In this procedure, a machine filters your blood. Eventually, you may need a kidney transplant.

What are the complications associated with GN? GN can lead to nephrotic syndrome, which causes you to lose large amounts of protein in your urine. This leads to a lot of fluid and salt retention in your body. You can develop high blood pressure, high cholesterol, and swelling throughout your body. Corticosteroids treat this condition. Eventually, nephrotic syndrome will lead to end-stage renal disease if it doesn’t come under control. The following conditions can also occur due to GN: acute kidney failure

chronic kidney disease

electrolyte imbalances, such as high levels of sodium or potassium

chronic urinary tract infections

congestive heart failure due to retained fluid or fluid overload

pulmonary edema due to retained fluid or fluid overload

high blood pressure

malignant hypertension, which is rapidly increasing high blood pressure

increased risk of infections