Glomerulonephritis

What is glomerulonephritis?

​Glomerulonephritis are inflammatory conditions that affect the glomeruli (small filters in the kidney that help remove waste and excess water from the blood) and small blood vessels in the kidneys. Glomerulonephritis may affect patients in many ways: some feel completely well while others may have severe body swelling if they develop nephrotic syndrome. Untreated kidney inflammation can lead to chronic kidney disease and kidney failure.  

What are the types of glomerulonephritis?

There are several types of glomerulonephritis, including:

• Post-streptococcal glomerulonephritis: Often occurs after a streptococcal infection such as strep throat.
• IgA nephropathy (Berger's Disease): Caused by deposits of IgA antibodies in the glomeruli.
• Goodpasture syndrome: An autoimmune disease that affects both the kidneys and the lungs.
• Membranous nephropathy: Characterised by thickened glomerular membranes leading to protein loss in the urine.
• Focal Segmental Glomerulosclerosis (FSGS): Scarring in some of the glomeruli, often linked to hypertension or obesity.
• Lupus nephritis: Associated with systemic lupus erythematosus, an autoimmune disease that affects various organs, including the kidneys.

What are the symptoms of glomerulonephritis?

Glomerulonephritis may not show any signs or symptoms at an early stage. It may be picked up during routine health screening detecting the presence of blood or protein in the urine. Certain types of glomerulonephritis can present with disease activity in other parts of the body as part of a multi-system autoimmune disease, for example, skin rash or joint inflammation in systemic lupus erythematosus (SLE).

A person may also present with acute symptoms such as:

• Headache, nausea, vomiting, fever, chills
• Swelling in the face, hands and feet
• Foamy urine, smoky or dark-coloured urine
• Less urine
• Feeling tired
• High blood pressure

When should you see a doctor?

You should seek medical attention if you notice any unusual changes in your general health, particularly related to kidney function. If routine health checks show abnormal levels of protein or blood in your urine, it is important to consult a healthcare professional. Persistent or unexplained fatigue, difficulty with urination or significant swelling in any part of your body may indicate an underlying issue with your kidneys.

Additionally, if you have a family history of kidney disease or a condition like lupus that increases your risk, regular monitoring and early intervention are crucial to preventing further complications. Early diagnosis and treatment of glomerulonephritis can help protect kidney function and reduce the risk of long-term damage.

What causes glomerulonephritis?

There are many causes of glomerulonephritis. Some are primary i.e., arising in the kidney, while others may be related to systemic diseases that affect the rest of the body. One of the most common secondary glomerulonephritis is lupus nephritis. To diagnose the underlying cause of glomerulonephritis, a kidney biopsy to obtain kidney tissue for microscopic examination is usually required.

Find out more about lupus nephritis:

What are the risk factors of glomerulonephritis?

While the causes of glomerulonephritis are linked to direct damage or systemic diseases affecting the kidneys, several risk factors may increase the likelihood of developing the condition. These risk factors include:

• Infections: Frequent or untreated infections, particularly streptococcal throat infections and viral infections like hepatitis B or C can heighten the risk of glomerulonephritis.
• Autoimmune disorders: Conditions such as lupus, which cause the body’s immune system to attack its own tissues, increase susceptibility to glomerular damage.
• Family history: Individuals with a family history of kidney disease are more likely to develop glomerulonephritis.
• Diabetes: Diabetes, particularly when poorly controlled, can lead to kidney damage raising the risk of glomerulonephritis.
• High blood pressure: Hypertension can damage the blood vessels in the kidneys making glomerulonephritis more likely over time.

How is glomerulonephritis diagnosed?

• Blood samples to look for medical conditions that cause glomerulonephritis.
• Urine samples to look for the presence of blood and protein in the urine.
• 24-hour urine collection to quantify the degree of protein leak in the urine.

Renal biopsy –This is a procedure that is done in the ward under local anaesthesia, in which a small sample of the kidney is obtained using an ultrasound guided biopsy needle for microscopic examination.

Certain types of glomerulonephritides are associated with malignant conditions such as bone marrow infiltration and solid organ tumours and further screening for these conditions via computed tomography scans, endoscopy or bone marrow studies may be required.

How is glomerulonephritis treated?​

Treatment will depend on the clinical symptoms, type of glomerulonephritis and severity of kidney impairment.