Glomerulonephritis, Chronic
What is it?
Chronic glomerulonephritis is a kidney disorder caused by slow, cumulative damage and scarring of the tiny blood filters in the kidneys. These filters, known as glomeruli, remove waste products from the blood. In chronic glomerulonephritis, scarring of the glomeruli impedes the filtering process, trapping waste products in the blood while allowing red blood cells or proteins to escape into the urine, eventually producing the characteristic signs of high blood pressure and swelling in the legs and ankles. The disorder may first come to one's attention because of high blood pressure. In others, fluid retention and/or foamy urine may be the first signs. Long-term inflammation and scarring (sclerosis) of the kidneys may lead to kidney failure in severe cases. Damage may progress without symptoms for months or years; by the time symptoms appear, the course of the disorder may be irreversible.
What Causes It?
- The specific cause of most cases of chronic glomerulonephritis is unknown.
- Viral infections, such as hepatitis B or C and acquired immunodeficiency syndrome (AIDS), may lead to chronic glomerulonephritis.
- Autoimmune disorders, such as systemic lupus erythematosus, or other causes of vasculitis (inflammation of small blood vessels) may cause chronic glomerulonephritis.
- Acute glomerulonephritis may, after a symptom-less period of many years, reappear as chronic glomerulonephritis.
Prevention
- There is no known way to prevent chronic glomerulonephritis.
Diagnosis
- Patient history and physical examination.
- Blood and urine tests.
- An ultrasound study of the kidneys may be performed to evaluate the size of the kidneys.
- A kidney biopsy may be performed. Under local anesthesia, the doctor inserts a needle into the kidney through the back to extract a small sample of tissue.
How to Treat It
- Antihypertensive drugs may be prescribed to reduce high blood pressure.
- Diuretics may be prescribed to reduce excess fluid retention and increase urine production.
- Your doctor may advise you to eat a low-protein, low-salt diet and to take iron or vitamin supplements. (Do not take iron supplements without your doctor's approval.)
- Steroid medication or immunosuppressive drugs may be prescribed for some patients.
- In severe cases where kidney failure occurs, dialysis may be necessary. Dialysis performs the functions of the kidney by removing waste products and excess fluid from the blood when the kidney cannot (see Renal Failure, Chronic for more information).
- A kidney transplant is an alternative to dialysis in cases of kidney failure.
When to Call a Doctor
- Call a doctor if you develop symptoms of chronic glomerulonephritis.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.