Glomerulonephritis (globe-mer-u-low-nuh-FRY-tis) is an inflammation of the tiny filters (glomeruli) in your kidneys. The glomerulus removes excess fluid, electrolytes, and waste products from your blood and drains them into your urine. Glomerulonephritis can occur suddenly (acute) or gradually (chronic).
Glomerulonephritis can occur alone or as part of another disease, such as lupus erythematosus or diabetes. Severe or long-term inflammation associated with glomerulonephritis can damage your kidneys. Treatment depends on the type of glomerulonephritis you have.
Symptoms
The features and symptoms of glomerulonephritis depend on whether you have acute or chronic nephritis and the cause of the disease. Your first signs may come from symptoms or the results of a routine urinalysis.
Signs and symptoms of glomerulonephritis include:
- Pink or cola-colored urine (hematuria) due to red blood cells in the urine.
- Frothy urine due to excess protein (proteinuria)
- High blood pressure (hypertension).
- Fluid retention (edema) with significant swelling of the face, hands, feet and abdomen
When to see a doctor
If you have signs or symptoms of concern, make an appointment with your doctor promptly.
Causes
Many diseases can cause glomerulonephritis. Sometimes the disease is familial, and sometimes the cause is unknown. Conditions that can cause inflammation of the kidney glomeruli include.
Infection
- Glomerulonephritis after streptococcal disease. Glomerulonephritis may occur within one to two weeks after recovery from a streptococcal infection or, rarely, a skin infection (impetigo). To fight the infection, your body produces extra antibodies that eventually deposit in the glomeruli and cause inflammation. Children are more likely to develop post-streptococcal glomerulonephritis than adults, and they are also more likely to recover quickly.
- Bacterial endocarditis. Bacteria can occasionally spread through your bloodstream and lodge in your heart, causing infection of one or more heart valves. If you have a heart defect, such as a damaged or artificial heart valve, you are at greater risk of developing this disease. Bacterial endocarditis is associated with glomerular disease, but the link between the two is not clear.
- Viral infections. Viral infections, such as human immunodeficiency virus (HIV), hepatitis B and hepatitis C, can trigger glomerulonephritis.
Immunologic diseases
- Lupus. Lupus is a chronic inflammatory disease that can affect many parts of your body, including the skin, joints, kidneys, blood cells, heart and lungs.
- Goodpasture's syndrome. Goodpasture syndrome is a rare immune lung disease that can mimic pneumonia, and it causes bleeding in your lungs as well as glomerulonephritis.
- IgA nephropathy. This primary glomerular disease is characterized by recurrent episodes of blood in the urine and is caused by the deposition of immunoglobulin A (IgA) in the glomeruli. IgA nephropathy can develop for years without apparent symptoms.
Vasculitis
- Polyarteritis. This form of vasculitis affects small and medium-sized blood vessels in many parts of the body, such as the heart, kidneys, and intestines.
- Polyangiitis granulomatosa. This form of vasculitis, formerly known as Wegener's granulomatosis, affects the small and medium-sized blood vessels in your lungs, upper airways, and kidneys.
Diseases that may cause glomerular scarring
- High blood pressure. This can damage your kidneys and impair their ability to function properly. Glomerulonephritis can also cause high blood pressure because it reduces kidney function and can affect the way your kidneys process sodium.
- Diabetic kidney disease (diabetic nephropathy). This can affect anyone with diabetes and usually takes years to develop. Good control of blood sugar levels and blood pressure may prevent or slow kidney damage.
- Focal segmental glomerulosclerosis. This condition is characterized by some scattered scarring of the glomeruli and may be caused by other diseases or may occur for unknown reasons.
In addition to these causes, glomerulonephritis has been associated with certain cancers, such as multiple myeloma, lung cancer, and chronic lymphocytic leukemia.
Complications
Glomerulonephritis can damage your kidneys, causing them to lose their ability to filter. As a result, dangerous amounts of fluid, electrolytes and waste products build up in your body.
Possible complications of glomerulonephritis include:
- Acute kidney failure. Loss of function of the filtering part of the glomerulus can lead to a rapid accumulation of waste products. You may need emergency dialysis - an artificial means of removing excess fluid and waste products from the blood - usually through an artificial kidney machine.
- Chronic kidney disease. Your kidneys gradually lose their ability to filter. Deterioration of kidney function to less than 10 percent of normal capacity can lead to end-stage renal disease, which requires dialysis or a kidney transplant to keep you alive.
- High blood pressure. Damage to your kidneys and the resulting buildup of waste products in your blood can raise your blood pressure.
- Nephrotic syndrome. In this syndrome, you have too much protein in your urine, causing you to have too little protein in your blood. Nephrotic syndrome may be associated with high blood cholesterol and swelling (edema) of the eyelids, feet, and abdomen.