| Kidneys are vital part of
our body. Their job is to remove waste products from the
blood, which are passed out of the body in urine. About a
million tiny filters in each kidney are called glomeruli. If
these filtering units get inflamed (swollen) this is called
glomerulonephritis. It means the kidneys are unable to work
properly. Salt and excess fluid can build up, leading to
complications such as high blood pressure and possibly kidney
failure. 
There are several types of glomerulonephritis; some are more
serious and long-term than others. Glomerulonephritis may be
short-lived (acute) and need minimal treatment. It may be
present for many years without causing trouble, or it can
develop into a long-term (chronic) condition.
Glomerulonephritis often follows an infection such as an
infection of the throat (pharyngitis). These are usually
autoimmune.
There are other conditions that cause glomerulonephritis and
swelling in the kidneys such as infection, tumour growth, or
disease within the kidney from long-term use of NSAIDs
(non-steroidal anti-inflammatory drugs) such as aspirin.
Glomerulonephritis is more common in men than women. It often
affects children and young people
Symptoms
There are several types of glomerulonephritis. If it has been
caused by an infection, the early symptoms may include a sore
throat. Inflammation in the kidneys may not be obvious at first.
Symptoms of kidney damage can come on suddenly or appear up to
three weeks after infection.
As a result of damage to the kidneys, glomerulonephritis can
cause:
- swollen ankles,
- a puffy face,
- problems breathing,
- pale skin,
- headaches,
- visual problems,·
- fever,
- loss of appetite and
- vomiting.
In addition, there may be small amounts of blood in the urine
and it may be cloudy. The normal urine output for an adult is
between 0.8 and 2.5 litres per day. This can vary according to a
number of factors such as how much you exercise and how hot or
cold you are. In severe cases of glomerulonephritis, some people
find that they do not urinate at all for 2-3 days. Once they are
able to urinate again, there may still be blood and protein in
the urine.
Some people get pain in the kidneys (in the upper back,
behind the ribs). Kidney pain may be due to a kidney infection
or kidney stones and not glomerulonephritis, so it is important
to see your GP for correct diagnosis.
Causes
Glomerulonephritis is usually caused by changes in the body’s
immune system. This is a complicated process involving antigens
and antibodies. Antigens are foreign substances in the body such
as proteins and toxins. Antibodies circulate in the blood and
their job is to get rid of antigens. If these antigens and
antibodies gather in the kidneys for any reason it can cause an
inflammatory reaction (swelling). This reaction may just affect
the kidney or may cause problems in other parts of the body.
Anyone who already has a chronic (long-term) autoimmune
condition, such as lupus is at risk of developing
glomerulonephritis. An autoimmune condition means that the body
attacks its own cells accidentally.
Commonly, acute glomerulonephritis is linked to streptococci
bacteria (beta haemolytic). This is referred to as acute post
streptococcal glomerulonephritis (ASGN) and can follow a throat
or skin infection.
Glomerulonephritis is also recognised as a serious
complication of some other infections including AIDS/HIV,
Hepatitis B, Hepatitis C, TB and syphilis. For this reason,
injecting drug users are particularly at risk of developing
glomerulonephritis.
Glomerulonephritis is a complication of many other diseases,
including:
- cancer and leukaemia,
- hodgkin’s disease,
- diabetes,
- Goodpasture’s syndrome (an autoimmune disorder that
affects the lungs and kidneys),
- liver disease, and
- sickle cell disease.
It is also recognised as a side effect of long-term use of
certain drugs. Such drugs include, non-steroidal
anti-inflammatory drugs (eg ibuprofen), gold injections (used in
the treatment of rheumatoid arthritis), lithium (used in the
treatment of depression) and penicillamine (used in the
treatment of arthritis). Your GP should monitor your kidney
function with renal tests if you are taking medicines that
affect the function of the kidney.
Diagnosis
Often there are no symptoms at all. Sometimes
glomerulonephritis is only diagnosed following a routine medical
check-up, or during tests related to having high blood pressure,
feeling tired or being pregnant. If you already have kidney
disease, your doctor may want to test for glomerulonephritis.
If you have glomerulonephritis, a urine test will show up
blood and protein in the urine. A range of tests will be carried
out to assess how well your kidneys are working (renal function
tests). These will include blood samples to find out levels of
sodium, chloride, potassium and urea. Tests may show that you
are producing less urine than usual overall.
If glomerulonephritis is suspected, the doctor may take a
throat swab (scraping some cells from the back of your throat) a
sample of to confirm the diagnosis.
Some varieties of glomerulonephritis are more serious than
others. Your doctor may remove and examine a small sample of
kidney tissue (a biopsy) to see how serious the
glomerulonephritis is. This is usually done using local
anaesthetic and a small needle. The test carries a small
risk of bleeding.
Please go to next page for
treatment
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