Glomerulonephritis

Glomerulonephritis is classified based on its cause, duration, or pathology. Below, some commonly recognised types based on various categorisations have been included.

• Based on duration:
  • Acute glomerulonephritis: This type of glomerulonephritis starts suddenly and is often triggered by post-streptococcal infections.
  • Chronic glomerulonephritis: This type of glomerulonephritis progresses slowly—over months or years—and may eventually lead to kidney failure.
• Based on cause or mechanism:
  • Primary glomerulonephritis: This type of glomerulonephritis originates in the kidneys and includes conditions such as IgA nephropathy and membranous nephropathy.
  • Secondary glomerulonephritis: This type of glomerulonephritis is caused by diseases that affect the whole body, such as lupus nephritis and diabetic nephropathy.
• Based on histological pattern:
  • Mesangial proliferative glomerulonephritis: This type of glomerulonephritis leads to an increase in the number of certain kidney cells called mesangial cells.
  • Membranoproliferative glomerulonephritis: This type of glomerulonephritis leads to thickening and alterations in the structure of the glomeruli (the kidney’s filtering units).
  • Focal segmental glomerulosclerosis (FSGS): This type of glomerulonephritis is characterised by scarring in some parts of the filtering structures of the kidneys.
  • Crescentic glomerulonephritis: This type of glomerulonephritis is characterised by crescent-shaped lesions in the kidney filters.

Glomerulonephritis can cause different symptoms that vary in severity depending on the cause. These include:

• Haematuria, which is the presence of blood in the urine.
• Proteinuria, which is frothy urine due to protein leakage.
• Oliguria, which is a reduced urine output.
• Swelling, which can appear as puffiness around the eyes, face, or legs.
• Systemic symptoms, which may include fever, joint pains, or rashes over other parts of body.

Glomerulonephritis occurs because of active inflammation in the kidneys, often caused by:

• Autoimmune diseases, such as lupus
• Infections, such as post-streptococcal glomerulonephritis
• Vasculitis, such as ANCA-associated vasculitis
• Exposure to certain toxins and drugs

The following tests and procedures are commonly performed to diagnose glomerulonephritis:

• Urine tests, including routine microscopy and protein creatinine ratio.
• Blood tests, including renal function tests and analysis of the levels of complement factors, such as C3 and C4, and autoimmune markers, such as ANA, c-ANCA, and p-ANCA.
• Kidney biopsy, which may be required for a definitive diagnosis.

Treatment depends on the underlying cause and severity of the condition. Below, various options have been enumerated.

• Therapeutic options: These include oral/IV steroids and immunosuppressive drugs, such as cyclophosphamide, tacrolimus, and mycophenolate mofetil (MMF).
• Procedures: These include plasmapheresis—to remove harmful antibodies from the blood—and dialysis (if kidney function is severely impaired).

See a doctor or kidney specialist if have a known family history of kidney disease or autoimmune condition or you notice any of the following:

• Blood in your urine
• Foamy urine or signs of protein in the urine
• Reduced urine output
• Swelling around the eyes, face, or legs
• Fever, joint pain, or skin rashes along with urinary symptoms
• High blood pressure or sudden weight gain

Glomerulonephritis cannot always be prevented, but the following steps may reduce the risk and help detect problems early:

• Infections should be treated promptly and completely.
• Underlying conditions, such as diabetes, lupus, or hypertension (high blood pressure) should be kept in check.
• Exposure to toxins or medications that can harm the kidneys should be avoided
• A healthy lifestyle with balanced diet, regular exercise, and proper hydration should be maintained.
• Regular check-ups and urine/blood tests if you are at higher risk due to family history or previous kidney problems is necessary.

Consult a nephrologist (kidney specialist), for the diagnosis and management of glomerulonephritis.