Glomerulonephritis is a disorder in which the kidneys become inflamed. As a result, the kidneys begin to leak protein and blood into the urine which can be seen under the microscope. Blood tests may also reveal a decreased ability of the kidneys to filter waste products. Edema or swelling may also develop due to the kidneys being less able to remove salt and water. Glomerulonephritis is important to diagnose because many of the causes can result in kidney failure if left untreated. Also, some of the causes of glomerulonephrits can suggest a systemic disorder which can affect other organs. Conversely, other forms can be relatively mild and present for many years without producing any significant damage. There are many different causes of glomerulonephritis and it is often necessary to perform a kidney biopsy to accurately diagnose which disorder is present. Some of the causes are related to infections, medications or diseases of the immune system. Many of the causes, however, have no specific cause and are termed idiopathic.
- Urine which becomes dark like tea or cola
- Swelling in the legs or around the eyes
- Worsening of blood pressure
- Weight gain or loss
- A decrease in kidney function on blood test
- Blood or protein leakage on urine test
However, patients may not have symptoms early in the course of a disease and the glomerulonephritis may be suggested by an abnormal blood or urine test.
A history and physical examination will be initially performed to search for some of the more common causes. More extensive testing will likely be done of the blood and urine. If these findings suggest glomerulonephritis, then a kidney biopsy will usually be recommended. This procedure will confirm the diagnosis but also give more information regarding the type of glomerulonephritis. This information is important for treatment and also for long-term prognosis.
Treatment decisions are guided by the specific type of glomerulonephritis as well as the severity. The mildest forms may be treated with blood pressure lowering and dietary modifications. However, many patients with glomerulonephritis require treatment with more potent medications that suppress the immune system. These may include prednisone, cyclophosphamide, mycophenolate mofetil and other similar medications.
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