What Is Chronic Glomerulonephritis?
Chronic glomerulonephritis is a kidney disorder caused by slow, cumulative damage and scarring of the tiny blood filters in the kidneys. These filters, known as glomeruli, remove waste products from the blood. In chronic glomerulonephritis, scarring of the glomeruli impedes the filtering process, trapping waste products in the blood while allowing red blood cells or proteins to escape into the urine, eventually producing the characteristic signs of high blood pressure and swelling in the legs and ankles. The disorder may first come to one’s attention because of high blood pressure. In others, fluid retention and/or foamy urine may be the first signs. Long-term inflammation and scarring (sclerosis) of the kidneys may lead to kidney failure in severe cases. Damage may progress without symptoms for months or years; by the time symptoms appear, the course of the disorder may be irreversible.
What Causes Chronic Glomerulonephritis?
- The specific cause of most cases of chronic glomerulonephritis is unknown.
- Viral infections, such as hepatitis B or C and acquired immunodeficiency syndrome (AIDS), may lead to chronic glomerulonephritis.
- Autoimmune disorders, such as systemic lupus erythematosus, or other causes of vasculitis (inflammation of small blood vessels) may cause chronic glomerulonephritis.
- Acute glomerulonephritis may, after a symptom-less period of many years, reappear as chronic glomerulonephritis.
Symptoms of Chronic Glomerulonephritis
- Blood or protein in the urine may be found on routine urinalysis
- Facial [uffiness in the morning
- Swelling of the legs or ankles or other parts of the body, due to fluid accumulation (edema)
- Shortness of breath during exertion due to anemia
- Headache or other symptoms of high blood pressure
- In severe cases, symptoms of kidney failure, including fatigue; seizures; nausea and vomiting; loss of appetite; overall itching; headache; easy bruising; frequent hiccups or bleeding; and impaired vision
- Increased pigmentation of the skin
- Abdominal pain
Chronic Glomerulonephritis Prevention
- There is no known way to prevent chronic glomerulonephritis.
Diagnosis of Chronic Glomerulonephritis
- Patient history and physical examination
- Blood and urine tests
- Chest x-ray to show fluid overload.
- An ultrasound study of the kidneys may be performed to evaluate the size of the kidneys.
- A kidney biopsy may be performed. Under local anesthesia, the doctor inserts a needle into the kidney through the back to extract a small sample of tissue.
- Computed tomography (CT) scan or abdominal ultrasound can be performed to show damage to the glomeruli.
How to Treat Chronic Glomerulonephritis
- Antihypertensive drugs may be prescribed to reduce high blood pressure.
- Diuretics may be prescribed to reduce excess fluid retention and increase urine production.
- Your doctor may advise you to eat a low-protein, low-salt diet and to take iron or vitamin supplements. (Do not take iron supplements without your doctor’s approval.)
- Steroid medication or immunosuppressive drugs may be prescribed for some patients.
- In severe cases where kidney failure occurs, dialysis may be necessary. Dialysis performs the functions of the kidney by removing waste products and excess fluid from the blood when the kidney cannot (Renal Failure, Chronic).
- A kidney transplant is an alternative to dialysis in cases of kidney failure.
When to Call a Doctor
- Call a doctor if you develop symptoms of chronic glomerulonephritis.
Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference
Simeon Margolis, M.D., Ph.D., Medical Editor
Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50
Updated by Remedy Health Media