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Monday, June 20, 2022

Glomerulonephritis

Glomerulonephritis

By Dr. Faozat Aragbaiye
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Glomerulonephritis is a group of diseases that cause inflammation and damage to the kidney’s filtering units. These disorders are the most common type of kidney disease. Glomeruli (filters) remove excess fluid, electrolytes and waste from the blood stream and pass them out through the urine.

Glomerulonephritis might come up suddenly(acute) or develop gradually (chronic). Severe or prolonged inflammation associated with glomerulonephritis can damage the kidneys.

Causes

Many conditions can cause glomerulonephritis . Sometimes the disease runs in families and sometimes the cause is unknown. Conditions that can lead to inflammation of the kidneys’ glomeruli include.

Infections

  • Post-streptococcal glomerulonephritis- Glomerulonephritis may develop a week or two after recovery from strep throat infection or rarely a skin infection (impetigo). Children are more likely to develop post streptococcal glomerulonephritis than are adults, and they are more likely to recover quickly.

Bacterial endocarditis- Bacteria can occasionally spread through the bloodstream to the heart and affect the heart valves.

Immune diseases

  • Lupus – A chronic inflammatory disease can affect many parts of the body, including the skin,, joints, kidneys, blood cells, heart and lungs.
  • Goodpasture’s syndrome- A rare immunological lung disorder that can mimic pneumonia. Goodpasture’s syndrome causes bleeding in the lungs as well as glomerulonepritis.

IgA nephropathy- This primary glomerular disease reslts from deposits of immunoglobulin A(IgA) in the glomeruli. IgA nephropathy can progress for years with no noticeable symptoms.

Vasculitis

  • Polyarteritis- This form of vasculitis affects small and medium blood vessels in many parts of the body such as the heart, kidneys and intestines.
  • Granulomatosis with polyangiitis- This form of vasculitis affects small and medium blood vessels in the lungs, upper airways and kidneys.

Other conditions causing scarring of the glomeruli

  • High blood pressure- This can damage the kidneys and impair its function. Glomerulonephritis can also lead to high blood pressure because it reduces the kidney function.
  • Diabetic kidney disease (diadetic nephropathy) –This can affect anyone with diabetes but usually taking years to develop. Good control of blood sugar levels and blood pressure might prevent or slow kidney damage.
  • Focal segmental glomerulosclerosis- This is characterized by scattered scarring of some of the glomeruli. This condition can result from another disease or occur for unknown reason.

In addition to the causes listed above, glomerulonephritis is associated with some cancers, such as multiple myeloma, lung cancer and chronic lymphocytic leukaemia.

Symptoms

Signs and symptoms of glomerulonephritis depend on the cause and the form.(acute or chronic) Signs and symptoms include ;

  • Pink or cola-coloured urine from red blood cells in the urine
  • Foamy urine due to excess protein
  • High blood pressure
  • Fluid retention (edema) with swelling in the face,hand, feet and abdomen.

Diagnosis

Diagnosis of glomerulonephritis is established with clinical assessment and the following laboratory investigations;

  • Urine test- A urinalysis might show red blood cells and red cast. Urinalysis might also show white blood cells, increased protein.
  • Blood tests- These can provide information about kidney damage and impairment of glomeruli by measuring levels of waste products ,such as creatinine and blood urea nitrogen.
  • Imaging tests- Kidney X-ray, ultrasound examination or CT scan for visualization of the kidneys.
  • Kidney biopsy- A kidney biopsy is almost always necessary to confirm the diagnosis of glomerulonephritis.

Treatment

Treatment of glomerulonephritis and the outcome depend on

  • Whether the infection is acute or chronic form
  • The underlying cause
  • The type and severity of the signs and symptoms.

In general , the goal of treatment is to protect the kidneys from further damage.

Complications

Glomerulonephritis can damage he kidneys, so that they lose their filtering ability. As a result, dangerous levls of fluid, electrolytes and waste build up in the body. Possible complications of glomerulonephritis include;

Acute kidnry failure; Chronic kidney disease; High blood pressure and nephritic syndrome.

Prevention

There may be no way to prevent most forms of glomerulonephritis. However these steps might be beneficial;

  • Seek prompt treatment of a step infection with a sore throat or impetigo.
  • To prevent infections that can lead to some forms of glomerulonephritis , such as HIV as hepatitis, follow safe sex guidelines and avoid intravenous drug use.
  • Control high blood pressure, which lessens the likelihood of damage to kidneys from hypertension,
  • Control the blood sugar to help prevent diabetic nephropathy.

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