Overview

Glomerulonephritis (gloe-MER-u-loe-nuh-FRY-tis) is swelling and irritation, called inflammation, of the tiny filters in the kidneys. The filters are called glomeruli (gloe-MER-u-lie). They remove fluid and waste from the bloodstream that then leave the body as urine.

Swelling and damage to the glomeruli may keep them from filtering as they should. This can lead to kidney and other issues.

Glomerulonephritis can come on at once, called acute, or little by little, called chronic.

Glomerulonephritis may be from a condition that only affects the kidneys. Or it may be part of a condition that affects other organs as well, such as lupus or infections. Treatment of glomerulonephritis depends on the type of glomerulonephritis.

Symptoms

Symptoms of glomerulonephritis may vary depending on whether you have the acute or chronic form. Symptoms also may vary depending on whether glomerulonephritis is part of an illness that damages only the kidneys or damages other organs too. You may notice no symptoms of chronic disease.

Glomerulonephritis symptoms may include:

• Cola- or tea-colored urine from red blood cells in the urine, called hematuria.
• Foamy or bubbly urine due to too much protein in the urine, called proteinuria.
• High blood pressure, also called hypertension.
• Buildup of fluid, called edema, that causes swelling in the face, hands, feet and belly or shortness of breath if the buildup is in the lungs.
• Upset stomach and vomiting because of the buildup of waste in the body.
• Tiredness.

When to see a doctor

Make an appointment with your healthcare professional right away if you have symptoms of glomerulonephritis.

Causes

Many conditions can cause glomerulonephritis. Sometimes the disease runs in families. Sometimes the cause is not known. The following conditions can lead to glomerulonephritis.

Autoimmune conditions

Autoimmune conditions are illnesses that happen when the immune system attacks healthy tissues by mistake. Autoimmune conditions that may cause glomerulonephritis include:

• Lupus. A lasting condition, systemic lupus erythematosus can inflame many parts of the body. These include the skin, joints, kidneys, blood cells, heart and lungs.
• Immunoglobulin A (IgA) nephropathy. IgA is an antibody that's the first defense against infections, especially in the airways and intestines. It can build up in the kidneys and cause swelling and irritation, called inflammation. This makes it harder for the kidneys to filter waste.
• Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). These conditions happen because of swelling and irritation, also called inflammation, of small arteries. They're part of a group of blood vessel diseases called vasculitis. They can damage the small arteries in the kidneys, lungs, skin and other organs.
• Anti-glomerular basement membrane (anti-GBM) disease. In this rare condition, the immune system attacks the glomeruli and causes glomerulonephritis. This most often leads to kidney failure. The condition also may damage the lungs. When it affects both the kidneys and the lungs, the condition is called Goodpasture syndrome.

Infections

Infections that can lead to glomerulonephritis include:

• Strep infection. Glomerulonephritis after a strep infection is called poststreptococcal glomerulonephritis. It may begin a week or two after having strep throat or a strep skin infection. Children are more likely to get poststreptococcal glomerulonephritis than adults are. And they're more likely to get well quickly.
• Bacterial endocarditis. Bacterial endocarditis is an infection of the inner lining of the heart's chambers and valves. Some people with endocarditis may get glomerulonephritis.
• Viral kidney infections. The response of the body to some viral infections may cause glomerulonephritis. Infections may include hepatitis B and hepatitis C.

Other causes

Sometimes chronic glomerulonephritis runs in families. One form passed through families is Alport syndrome. It also might damage hearing or vision.

Also, glomeruli may get damaged without being inflamed. For instance, long-term diabetes may slowly damage the glomeruli and affect how the kidneys work without the swelling and irritation, called inflammation, of the glomeruli.

Risk factors

Some autoimmune diseases and infections are linked to glomerulonephritis.

Complications

Possible complications of glomerulonephritis include:

• Acute kidney injury (AKI). AKI is a quick drop in how well the kidneys work. It happens within days of kidney damage. Sometimes, AKI leads to kidney failure. Kidney failure causes a big buildup of waste, toxins, fluid and salt in the body. The only treatment for kidney failure is use of a machine that filters waste from the kidneys, called dialysis, or a kidney transplant.

  Treatment for glomerulonephritis soon after it starts often can prevent long-term damage to the kidneys.

• Chronic kidney disease. Damage to the kidneys may be bad enough that they don't work as well as they used to. This is called chronic kidney disease. Chronic kidney disease may get worse over time and lead to kidney failure. Treatment of kidney failure is either dialysis or a kidney transplant.
• High blood pressure. Damage to the glomeruli from swelling and irritation or scarring can lead to higher blood pressure.
• Nephrotic syndrome. Damage to the glomeruli may cause protein to leak into the urine. Nephrotic syndrome is when there's high blood cholesterol, swelling of the legs, shortness of breath, and a large amount of protein in the urine and too little in the blood.

Prevention

There may be no way to prevent some forms of glomerulonephritis. But here are some steps that might help:

• Get treatment right away for a sore throat or skin infections.
• To prevent viral infections such as HIV and hepatitis that can cause glomerulonephritis, follow safer sex guidelines. Don't use drugs that you shoot with a needle.
• Manage high blood pressure to lower the chance of it damaging your kidneys more.
• If you have a condition that can cause kidney disease, such as lupus, have regular blood and urine testing for signs of kidney damage.

Diagnosis

A healthcare professional may diagnose glomerulonephritis during testing for another illness or during routine testing during a wellness visit. Tests to see how the kidneys are working include:

• Urine test. Called a urinalysis, this test can show signs of the kidneys not working well. For instance, the test may show red blood cells and proteins that shouldn't be in urine. Or it may show white blood cells that are a sign of swelling and irritation, called inflammation.
• Blood tests. Study of blood samples can show higher than expected levels of waste products in the bloodstream or antibodies that may mean an autoimmune condition. Blood tests also can find signs of infection.
• Imaging tests. An X-ray, an ultrasound or a CT scan can show the shape and size of the kidneys.
• Kidney biopsy. For this test, a healthcare professional uses a special needle to take small pieces of kidney tissue to look at under a microscope. A biopsy can confirm a diagnosis and show tissue damage.

Treatment

Treatment of glomerulonephritis depends on:

• Whether you have an acute or chronic form of the condition.
• The cause.
• Your symptoms and how bad they are.

Most often, the goal of treatment is to protect your kidneys from more damage and to keep your kidneys working.

Depending on the cause of glomerulonephritis, treatments might include:

• Antibiotics for bacterial infections.
• Medicines that lower the immune system response. These may help with autoimmune conditions, such as lupus. A common type of these medicines is a corticosteroid, such as prednisone.
• Water pills, also called diuretics, to ease swelling and lower blood pressure.
• Blood pressure pills, mainly angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) to lower blood pressure. They also can lower the amount of protein in the urine.
• Plasmapheresis, a process that filters the blood to take out protein that is not typical. This form of treatment is not common. But it may help treat anti-GBM disease and Goodpasture syndrome.
• Dialysis, which uses a device that filters blood to treat acute kidney failure.
• Kidney transplant for kidney failure.

Researchers are studying new medicines for glomerulonephritis.

Lifestyle and home remedies

If you have a kidney condition, the following lifestyle changes may help:

• Use less salt. This can help with fluid buildup, swelling and high blood pressure.
• Eat less protein. This can slow the buildup of waste in your blood.
• Stay at a healthy weight.
• Get regular exercise.
• Manage your blood sugar level if you have diabetes.
• Manage high blood pressure if you have it.
• Quit smoking.

Coping and support

Living with a chronic illness can bring up feelings such as stress and worry. If you have chronic glomerulonephritis or chronic kidney failure, joining a support group might help you cope.

To find a support group, ask your healthcare team or contact the National Kidney Foundation to find the chapter nearest you.

Preparing for an appointment

You'll likely start by seeing your main healthcare professional. If lab tests show that you have kidney damage, your healthcare professional might send you to a doctor who specializes in kidney conditions, called a nephrologist.

What you can do

To get ready for your appointment, ask if there's anything you need to do ahead of time, such as limit what you eat and drink. Make a list of the following:

• Your symptoms, including any that don't seem linked to your kidneys, and when they began.
• All the medicines, vitamins and supplements you take, including dosages.
• Your key medical history, including any other medical conditions you or your family members have or had.

Take a family member or friend along, if possible, to help you remember the information you get.

When you have follow-up appointments after a diagnosis of glomerulonephritis, you may want to ask these questions:

• How well are my kidneys working? Has this changed since the last exam?
• When should I schedule lab work or another appointment?
• How do the medicines you prescribed work? What side effects might I have?
• Will I need dialysis?
• What help can I get to manage linked conditions, such as support with diet planning or exercise?
• What do I do if I miss a dose of a prescription?
• When should I get urgent care?
• Are there brochures or other printed information that I can have? What websites do you suggest?