Doctor Blogs

Inflammation of kidney
by: Dr. Jitendra Kumar
Director Nephrology and Kidney Transplant Unit

Glomerulonephritis refers to a range of kidney conditions which cause inflammation in the very small blood vessels in the kidneys, known as glomeruli. It can be acute, which means it starts suddenly, or chronic, when the onset is gradual. But the consequences can be fatal.

Role of glomeruli

Our kidney contains millions of glomeruli. These are tiny filters in the kidneys. If it becomes damaged, the kidney can no longer remove waste and excess fluids efficiently. If the illness continues, the kidneys may stop working completely, resulting in kidney failure because blood and protein cannot be filtered, and are excreted in the urine.

Symptoms

Acute glomerulonephritis

  • Puffiness of the face on waking up
  • Urine that is brown or contains traces of blood
  • Decreased urination
  • Fluid in the lungs leading to coughing and shortness of breath
  • High blood pressure

Chronic glomerulonephritis: Develops over the years, often without apparent symptoms. But complete kidney failure can result from it

  • Blood or protein in the urine
  • High blood pressure
  • Swollen ankles or face, because of water retention
  • Urinating often during the night
  • Bubbles or foam in the urine, caused by excess protein

A person with kidney failure may have a poor appetite, nausea and vomiting. They may feel tired, and have difficulty sleeping, with muscle cramps during the night. Their skin may be dry and itchy. Some patients have intense kidney pain in the upper back, behind the ribs.

Causes:

The acute disease may be caused by infections such as strep throat. Long-term use of certain medications, including non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or aspirin, can increase the risk. People with systemic diseases, especially diabetes, and some autoimmune diseases, such as lupus, are at higher risk.

Chronic glomerulonephritis sometimes, the disease runs in the family. This kind often shows up in young men who may also have hearing loss and vision loss. Some forms are caused by changes in the immune system.

Diagnosis

Blood tests will help the doctor tell what type of illness you have and how much it has hurt your kidneys. In some cases, a test called a kidney biopsy may be needed. A biopsy will help the doctor plan the best treatment for you.

Treatment

Treatment depends on whether the condition is acute or chronic, the underlying cause, and the severity of symptoms.

Temporary dialysis may be necessary in cases of acute glomerulonephritis. The patient will probably have to reduce fluid intake, and avoid drinks or food containing alcohol or high levels of protein, salt or potassium. Diuretics can help to reduce hypertension, and slow kidney function decline, and blood pressure medication relaxes the blood vessels.

A person with immune problems may undergo plasmapheresis, a mechanical process that removes plasma with antibodies from the blood, and replaces it with other fluid or donated plasma. Kidney transplant may be possible, if the patient's health allows it. Otherwise, dialysis may be the only option.

Preventing glomerulonephritis

  • Seek medical attention for a strep infection that causes a sore throat or impetigo
  • Keep diabetes and blood pressure under control
  • Practice safe sex and avoid illegal intravenous drug use.
  • Choosing a healthy lifestyle with plenty of exercise, quality sleep and a healthy diet. These will reduce the risk of infections and hypertension.