Glomerulonephritis

What is glomerulonephritis?

Glomerulonephritis is a type of kidney disease that involves the glomeruli. The glomeruli are very small, important structures in the kidneys that supply blood flow to the small units in the kidneys that filter urine, called the nephrons. During glomerulonephritis, the glomeruli undergo changes and impair the kidney's ability to filter urine.

What causes glomerulonephritis?

Glomerulonephritis is caused by several different disease states, including the following:

systemic immune disease such as systemic lupus erythematosus (SLE, or lupus)
other systemic diseases may include:
- polyarteritis nodosa group - an inflammatory disease of the arteries.
- Wegener vasculitis - A progressive disease that leads to widespread inflammation of all of the organs in the body.
- Henoch-Schönlein purpura - A disease usually seen in children that is associated with purpura (small or large purple lesions on the skin and internally on the organs) and involves multiple organ systems.
Glomerulonephritis can also result from a gene passed on from carrier parents who have no features, minimal or more severe features of the problem, to their children, who are affected with the disorder in 25 to 50 percent of the cases.
In children, another cause of glomerulonephritis is from a streptococcal infection, such as strep throat or upper respiratory infection. Glomerulonephritis usually occurs more than one week after an infection. This is often referred to as acute poststreptococcal glomerulonephritis, or APSGN.
IgA Necphropathy, also called Berger's disease, is a more common cause of Glomerulonephritis.

What are the symptoms of glomerulonephritis?

The following are the most common symptoms of glomerulonephritis. However, each child may experience symptoms differently. Symptoms may include:

dark brown-colored urine (from blood)
diminished urine output
fatigue
lethargy
increased breathing effort
headache
high blood pressure
seizures (may occur as a result of high blood pressure)
rash, especially over the buttocks and legs
weight loss
joint pain
pale skin color
fluid accumulation in the tissues (edema)

The symptoms of glomerulonephritis may resemble other conditions and medical problems. Always consult your child's physician for a diagnosis.

How is glomerulonephritis diagnosed?

In addition to a thorough physical examination and complete medical history, your child's physician may recommend the following diagnostic tests:

throat culture
urine tests
blood tests
electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
echocardiogram
renal ultrasound (Also called sonography.) - a non-invasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney, and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.
chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
renal biopsy - a procedure where a small sample of tissue is taken from the kidney through a needle. The tissue is sent for special testing to determine the specific disease.

Treatment for glomerulonephritis:

Specific treatment for glomerulonephritis will be determined by your child's physician based on:

your child's age, overall health, and medical history
the extent of the disease
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Unfortunately, some types of glomerulonephritis cannot be cured. Therefore, treatments focus on slowing the progression of the disease preventing complications.

Treatment for glomerulonephritis may include:

fluid restriction
decreased protein diet
decreased salt and potassium diet
medication, such as:
- diuretics
- blood pressure medications
- phosphate binders - medications to decrease the amount of the mineral phosphorus in the blood.
- immunosuppressive agents
dialysis
Dialysis may be required for short-term or long-term therapy. Dialysis is a medical treatment to remove wastes and additional fluid from the blood after the kidneys have stopped functioning.

If glomerulonephritis does not resolve, long-term kidney failure may need to be addressed.

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