Glomerulonephritis - Types, Causes, Diagnosis, Treatment, Prevention

Glomerulonephritis (Nephritic / Nephrotic Syndrome)

What is Nephritic – Nephrotic syndrome?

Do You Have Any of these?

  • Foamy urine
  • Blood in the urine
  • Swelling of the feet, hands, around the eyes
  • High blood pressure
  • Rise in blood creatinine levels

Our kidneys have 1 - 1.2 million nephrons which are the functional unit of kidney. They are specialized cells containing glomeruli, tubules, interstitium and vascular compartment which functions to purify the blood of waste products and also have hormonal functions helping to maintain homeostasis(1 Trusted Source
Basics of renal anatomy and physiology

Go to source

Glomerulonephritis is the term used to describe group of diseases that damage the glomerulus(2 Trusted Source

Go to source
When kidney insult occurs, it cannot clear the waste toxins and fluid gets accumulated leading to volume overload, which if untreated may lead to permanent kidney damage.

The spectrum of glomerular diseases leads to inflammation of glomerulus and leakage of red blood cells and various molecular weight proteins. Albumin is the major protein which leaks leads to loss of the oncotic pressure (water absorbing capacity) in the blood vessels leading to leakage of water out of the circulatory system amounting to fluid accumulation in the face, legs ankles and swelling of whole body(3 Trusted Source
Histology, Kidney and Glomerulus

Go to source

Classification of Glomerulonephritis

  • Acute Glomerulonephritis – sudden occurrence of nephritic syndrome after an infection, inflammation, drug related(2 Trusted Source

    Go to source
  • Chronic Glomerulonephritis – slowly progressive nephritic-nephrotic syndrome leading to permanent kidney damage and need for kidney replacement therapy(2 Trusted Source

    Go to source

Symptoms and Signs of Glomerulonephritis

  • Generalised swelling of whole body
  • Protein leak in the urine
  • Low blood albumin
  • High blood pressure
  • Blood in urine
  • Loss of filtration function
  • Joint pains/blood in sputum / skin rashes (may point to specific etiology)
  • Symptoms and Signs of Glomerulonephritis

    What are the Causes of Glomerulonephritis?

    Broadly we can divide the causes as follows:

    A. Autoimmune diseases: The native immune system creates antibodies against the own antigens leading to damage to many organs. It can affect the skin, brain, blood system, kidneys, heart, lung etc. It may also affect specific organs.

    In an autoimmune disease, the immune system creates autoantibodies, which are antibodies or immunoglobulins that attack the body itself. Autoimmune diseases may be systemic and affect many parts of the body, or they may affect only specific organs or regions(6 Trusted Source
    Nature and functions of autoantibodies

    Go to source

    B. Familial/hereditary: These diseases run in families with early presentation like Alport syndrome, congenital nephrotic syndrome, thin basement membrane disease. Symptom presentation like early age of onset and genetic study will confirm diagnosis(7 Trusted Source
    Familial risks of glomerulonephritis - a nationwide family study in Sweden

    Go to source

    C. Infective: Glomerular disease sometimes develops rapidly after an infection in other parts of the body. Acute post-streptococcal glomerulonephritis (PSGN), HIV and some other infections(8 Trusted Source
    Glomerular Diseases Associated with Infection

    Go to source

    D. Sclerotic Diseases: This means scarring of the glomeruli by various systemic and local causes. Examples: diabetes and lupus disease.

    E. Idiopathic: Cause of the disease is unknown.


    How do you Diagnose Glomerulonephritis?

    Clinical symptoms and signs Blood investigations(2 Trusted Source

    Go to source

    • Urine routine examination
    • Kidney function tests (haemoglobin, urea, creatinine, sodium, potassium, bicarbonate, total protein, almumin, HIV, HbsAg, HCV)
    • 24 hrs urine protein estimation
    • Special tests – Antinuclear antibody, complement C3/C4, Antinuclear antibody profile, genetic tests etc.
    Diagnosis of Glomerulonephritis
    • Kidney biopsy – After Nephrologist opinion, it is a process by which a small kidney sample is taken under ultrasound guidance with help of a biopsy needle under local anaesthesia and examined in microscope by the trained Kidney pathologist after staining the tissue to give confirmed diagnosis of the type of glomerular disease.

    How do you Treat Glomerulonephritis?

    Conservative measures:

    • Total fluid restriction
    • Total salt intake < 5gm/day
    • Control of blood pressure
    • Diuretics
    • Protein intake (as per nephrologist advice)
    • Anti proteinuric medications
    Treatment of Glomerulonephritis


    Under special circumstances after confirmation of diagnosis by kidney biopsy (if applicable) to start on steroids, immunosuppressive medications , plasmapheresis as per the treating nephrologist advise.


    What are its Complications?

    The Complications of Glomerulonephritis are as follows:(2 Trusted Source

    Go to source

    • Fluid overload
    • Delay in detection and treatment may lead to progression to Chronic kidney disease
    • Increased susceptibility to other infections
    • Malnutrition
    • Cardiovascular morbidity
    • Hypertensive retinopathy
    • End-stage renal disease
    • Malignant hypertension
    Complications of Glomerulonephritis

    How do you Prevent Glomerulonephritis?

    • Early detection of renal diseases
    • Personal hygiene
    • Lifestyle modifications
    • Early detection of hypertension and diabetes
    • Nephrologist advise
    • Proper nutritious diet
    • Regular excercise

    Latest Publications and Research on Glomerulonephritis (Nephritic / Nephrotic Syndrome)

    Recommended Reading