Glomerulonephritis

Date updated: April 05, 2007
Content provided by MayoClinic.com

Your kidneys are complex organs whose primary task is to remove wastes, excess fluid and unneeded electrolytes from your body. Any condition that interferes with kidney function can lead to a potentially dangerous buildup of waste products in your bloodstream.

Glomerulonephritis (glo-mer-u-lo-nuh-FRI-tis) is a type of kidney disease that hampers your kidneys' ability to remove waste and excess fluids. Also called glomerular disease, glomerulonephritis can be acute, referring to a sudden attack of inflammation, or chronic, which comes on gradually.

Glomerular disease can be part of a systemic disease, such as lupus or diabetes, or it can be a disease by itself - primary glomerulonephritis. Treatment depends on the type of glomerulonephritis you have.

Signs and symptoms

Signs and symptoms of glomerulonephritis may depend on whether you have the acute or chronic form, and the cause. Your first indication that something is wrong may come from symptoms or from the results of a routine urinalysis. Signs and symptoms may include:

• Cola-colored or diluted iced-tea-colored urine from red blood cells in your urine (hematuria)
• Foam in the toilet water from protein in your urine (proteinuria)
• High blood pressure (hypertension)
• Fluid retention (edema) with swelling evident in your face, hands, feet and abdomen
• Fatigue from anemia or kidney failure
• Less frequent urination than usual

Causes

Your kidneys are two bean-shaped, fist-sized organs situated at the small of your back, just below your rib cage, one on each side of your spine. Blood enters your kidneys through arteries from your aorta, the large artery that carries blood away from your heart. Each kidney contains approximately 1 million tiny filters (glomeruli), each of which is attached to the opening of a small fluid-collecting tube (tubule). Each glomerulus and tubule form a nephron, the functional unit of the kidneys.

The glomeruli filter your blood as it passes through your kidneys. After being filtered by the glomeruli, blood travels through veins in the kidneys back to your bloodstream. The waste, after being modified by the tubules, goes to your bladder as urine through a tube from each kidney (ureter) and passes out of your body when you urinate.

Every day about 1.5 to 2 quarts of extra water with waste products leave your body as urine. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body, a condition known as kidney failure.

Many causes of glomerulonephritis
Glomerulonephritis is one disorder that can lead to kidney failure. There are many causes of glomerulonephritis. They include those related to infections, immune diseases, inflammation of the blood vessels (vasculitis) and conditions that scar the glomeruli.

Often, however, the exact cause is initially unknown. Here are some of the known causes:

Infections

• Post-streptococcal glomerulonephritis. Glomerulonephritis may develop after a strep infection in your throat or, rarely, on your skin (impetigo). Post-infectious glomerulonephritis is becoming less common, most likely because of rapid and complete antibiotic treatment of most streptococcal infections.
• Bacterial endocarditis. Bacteria can occasionally spread through your bloodstream and lodge in your heart, causing an infection of the valvular tissues inside the heart. Those at greatest risk are people with a heart defect, such as a damaged or artificial heart valve.
• Viral infections. Among the viral infections that may trigger glomerulonephritis are the human immunodeficiency virus (HIV), which causes AIDS, and the hepatitis B and hepatitis C viruses, which affect the liver and can become chronic infections.

Immune diseases

• Lupus. A chronic inflammatory disease, lupus can affect many parts of your body, including your skin, joints, kidneys, blood cells, heart and lungs.
• Goodpasture's syndrome. A rare immune lung disorder that may mimic pneumonia, Goodpasture's syndrome causes bleeding (hemorrhage) into your lungs as well as glomerulonephritis.
• IgA nephropathy. Characterized by recurrent episodes of blood in the urine, this condition results from deposits of immunoglobulin A (IgA) in the glomeruli. IgA nephropathy can progress for years with no noticeable symptoms. The disorder seems to be more common in men than in women.

Vasculitis

• Polyarteritis. This form of vasculitis affects small and medium blood vessels in many parts of your body, such as your heart, kidneys and intestines.
• Wegener's granulomatosis. This form of vasculitis affects small and medium blood vessels in your lungs, upper airways and kidneys.

Conditions that cause scarring of the glomeruli

• High blood pressure. Damage to your kidneys and their ability to perform their normal functions can occur as a result of high blood pressure. Glomerulonephritis can also cause high blood pressure because it reduces kidney function.
• Diabetic kidney disease. Possibly the most common cause of end-stage kidney disease in the United States, diabetic kidney disease (diabetic nephropathy) can affect anyone with diabetes. Diabetic nephropathy usually takes years to develop, and maintaining good control of blood sugar levels and controlling blood pressure may prevent or slow the kidney damage.
• Focal segmental glomerulosclerosis. Characterized by scattered scarring of some of the glomeruli, this condition may result from another disease or occur for no known reason.

Chronic glomerulonephritis sometimes develops after a bout of acute glomerulonephritis. In some people there's no history of kidney disease at all, and the first indication of chronic glomerulonephritis is chronic kidney failure. Infrequently, chronic glomerulonephritis runs in families. In many cases, no one knows the cause.

Glomerulonephritis is a kidney disease in which the kidneys' filters become inflamed and scarred, and slowly lose their ability to remove wastes and excess water from the blood to make urine. It is a rare kidney inflammatory condition that leads to the destruction of the glomeruli. It effects 4 out of 10,000 people.

Kidney disease of diabetes, IgA nephropathy, and lupus nephritis are some types of glomerulonephritis. Nephrotic Syndrome is a group of signs and symptoms that may accompany glomerulonephritis and other conditions that affect the filtering ability of the glomeruli.

High protein levels in the urine resulting in low protein levels in the blood, high cholesterol, and swelling of the eyelids, feet and abdomen characterize the syndrome.