Also known as: Glomerular Nephritis
Glomerulonephritis, inflammation of the glomeruli (small filtering structures in the kidney) is an umbrella name for a range of conditions generally caused by an abnormality in the immune system, which is triggered for unknown reasons.
Glomerulonephritis is one of the major causes of renal failure, and the main cause of kidney disease in young adults. It is estimated that 20 per cent of those on dialysis have glomerulonephritis.
Medical text written February 2003 by Contact a Family. Approved February 2003 by the Medical Advisor (Consultant Nephrologist) of the National Kidney Research Fund, UK. Last updated February 2010 by David Goldsmith, Consultant Kidney Physician, Guy’s Hospital, London, UK.
People with glomerulonephritis may have some or all of the following symptoms: haematuria (blood in the urine), proteinuria (protein in the urine), swelling in parts of the body due to water and salt retention, progressive or chronic renal failure and high blood pressure (hypertension). Existing treatment consists of careful control of all these symptoms, especially blood pressure.
The identification of the specific form of glomerulonephritis in an individual will depend on the results of a kidney biopsy:
- minimal change disease, one of the causes of nephrotic syndrome does not lead to renal failure and is common in children
- focal and segmental glomerulosclerosis includes nephrotic syndrome, hypertension and renal failure, and is commoner in young adults
- membranous nephropathy is characterised by proteinuria or nephrotic syndrome, renal failure, and is common in middle age
- immunoglobulin A (IgA) nephropathy is the commonest form of glomerulonephritis and manifests with proteinuria, hypertension and slow renal failure. It mainly affects young adults
- acute diffuse glomerulonephritis, which usually follows infection, tends to resolve and is now rare in Western countries. It is characterised by haematuria/proteinuria and hypertension leading to acute nephritis
- the rare crescentic glomerulonephritis leads to rapid renal failure and is more common in middle age/older patients.
The glomerular filters in the kidney take blood under pressure and filter out excess water, waste products and some salts. These filters sometimes become inflamed and enlarged, usually due to the white blood cells in the body’s immune system turning against the body. This causes the inflammation. The underlying mechanism of disease is not well understood and is the subject of much current research. This inflammation can develop at any time and an occurrence may be triggered by an event such as an infection in a person with a genetic susceptibility to the disease. Glomerulonephritis can be caused by systemic diseases, such as lupus and rheumatoid arthritis.
It is unknown why the inflammation of the kidneys gets better in some people once treatment starts while in others the kidneys develop a scarring process and continue to decline.
A variety of drugs are used to get the balance right and this differs from person to person. In some cases, the use of non-specific drugs which affect the immune system (eg steroids) may help. In all cases the aim of treatment is to prevent the kidneys completely failing to function. If kidney failure takes place, individuals will need dialysis or transplantation.
Information and support in the UK for glomerulonephritis is provided by the Kidney Research UK (see entry Kidney disease).