Glomerulonephritis (GN)

What is glomerulonephritis?

Glomerulonephritis is a type of kidney disease. It involves damage to the glomeruli (tiny filters) inside your kidneys. If you have glomerulonephritis, your kidneys can have trouble removing waste and fluid from your body. Many mild cases resolve with treatment. If the condition becomes severe, it can lead to kidney failure.

How do glomeruli help your kidneys?

Glomeruli are tiny filtering units made of capillaries (tiny blood vessels) in your kidneys. You have almost a million of them. Their job is to remove waste and extra fluid from your blood. It’s the first step in the process of making pee. If something damages them, they can’t do their job. This means your kidneys may not work as well.

Are there different types of glomerulonephritis?

When glomerulonephritis starts suddenly, it’s called acute glomerulonephritis. When it happens slowly and lasts a while, it’s called chronic glomerulonephritis. Some people can have an acute attack and then a chronic condition years later.

What are the symptoms of glomerulonephritis?

People with glomerulonephritis often don’t experience any warning signs of the disease. But symptoms can include:

• Blood in your pee, which may make it look brown, pink or red.
• Nausea.
• Rash
• Shortness of breath.
• Pain in your joints or abdomen.
• Peeing less often or more often than usual.
• Swelling in your legs or face.
• Pee that appears foamy or bubbly.
• High blood pressure.
• Jaundice.
• Weight loss or loss of appetite.

Contact a healthcare provider if you have one or more of these symptoms. Many other health conditions can cause similar symptoms. Your healthcare provider can evaluate your symptoms and tell you if glomerulonephritis is a possible diagnosis.

What causes glomerulonephritis?

The reason glomerulonephritis appears is often unknown. But causes may include:

• A complication of bacterial endocarditis, an infection in your heart valves.
• A complication of infections like strep throat, HIV or hepatitis C.
• Problems with your immune system attacking healthy parts of your body, such as with lupus.
• Anti-GBM disease (formerly Goodpasture syndrome), a group of autoimmune diseases that affect your lungs and kidneys.
• IgA nephropathy, a kidney disease caused by a buildup of abnormal IgA antibody (immunoglobulin A).
• Rare diseases that inflame blood vessels like granulomatosis with polyangiitis (formerly Wegener’s disease), microscopic polyangiitis, Henoch-Schönlein purpura, or eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome).
• Genetics, meaning it runs in your biological family (this is rare).
• Certain types of cancer (like multiple myeloma).

What are the risk factors for glomerulonephritis?

Not everyone with risk factors will develop glomerulonephritis. And, not everyone with the condition has a risk factor. But, the following are known risk factors:

• A personal or family history of kidney disease.
• Taking certain medications.
• Exposure to specific toxins.
• Having certain viral infections (like strep) or bacterial infections (bacterial endocarditis).
• Having an autoimmune condition.

What are the complications of glomerulonephritis?

Some people develop complications from glomerulonephritis. Glomerulonephritis affects your kidney’s ability to remove waste from your bloodstream. Specific complications include:

• Blood clots, including deep vein thrombosis (DVT) or pulmonary embolism (PE).
• Chronic kidney disease (CKD).
• Hypertension (high blood pressure).
• High cholesterol.
• Kidney failure, which can happen quickly or after several years.
• Nephrotic syndrome (nephrosis), with protein in your pee, often leading to foamy pee and swelling in your body.

How is glomerulonephritis diagnosed?

Glomerulonephritis may not produce symptoms. That’s why it’s often discovered during tests for another concern. If a healthcare provider suspects you have glomerulonephritis, they may refer you to a kidney specialist and/or you may have the following tests:

• Urine test: This test will determine if you have protein or blood in your urine.
• Blood test: This test will measure the level of creatinine (a waste product your kidneys filter) in a sample of your blood.
• Kidney biopsy: A healthcare provider will use a needle to remove a piece of tissue from your kidney and send it to a lab for analysis.
• Imaging tests: Your provider may order imaging tests such as ultrasound, X-ray or CT scan. These tests check the size and shape of your kidneys, look for blockages and help diagnose other problems.

What is the treatment for glomerulonephritis?

Treatment depends on what’s causing the condition and if you have kidney damage. The goal of treatment is to reduce any further damage.

Sometimes, treating the underlying cause, like taking medication to manage high blood pressure, is all that’s necessary. If the cause is due to infection, antibiotics can treat the infection.

At other times, your healthcare provider may recommend:

• Changes to your diet so that you eat less protein and salt, which put extra strain on your kidneys.
• Immunosuppressants, if a problem with your immune system causes glomerulonephritis.
• Medicine to lower your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin blockers (ARB).
• Corticosteroids to decrease inflammation.
• Dialysis, which helps clean your blood, remove extra fluid and control blood pressure.
• Diuretics (water pills) to reduce swelling and remove excess fluid from your body.
• Plasmapheresis, a special process that filters protein from your blood.

Can I prevent glomerulonephritis?

There’s no proven way to prevent glomerulonephritis. Adopting a healthy lifestyle is the best approach, though some practices may help, such as:

• Eating a balanced diet and unprocessed food.
• Managing high blood pressure with a low-salt diet, exercise and medication.
• Managing diabetes.
• Preventing infections by practicing good hygiene and safe sex.
• Seeing a healthcare provider whenever you think you have an infection like strep throat.
• Using any over-the-counter (OTC) pain medication as directed.

What is the outlook for people with glomerulonephritis?

Different people have different outcomes with glomerulonephritis depending on what kind of glomerulonephritis you have. Some cases go away over time without any treatment. Some people have no symptoms of the disease and only find out because they have a blood or urine test for another condition. But it can cause kidney damage and lead to kidney failure without treatment.

How can I manage glomerulonephritis?

If you have glomerulonephritis, get your kidneys checked on a regular basis. Follow medical advice and take medication as prescribed by your provider to manage the cause. You also may have to limit the amount of salt and protein you eat. These ingredients put stress on your kidneys.

Is glomerulonephritis a serious disease?

It can lead to kidney disease or kidney failure in some people. Both of these conditions are serious. It’s important to see your healthcare provider each year so they can be made aware of changes in your body or health history. This can help them detect conditions like glomerulonephritis, which causes no symptoms in some people.

When should I see my healthcare provider?

Contact your healthcare provider if you have symptoms like:

• Blood in your pee (hematuria) or other changes in the appearance of your pee.
• Changes in how often you pee.
• Joint pain.
• Swelling in your legs or face.
• Shortness of breath.

What questions should I ask my healthcare provider?

Consider asking your healthcare provider:

• What’s causing my glomerulonephritis?
• Can you treat the cause?
• How are my kidneys functioning?
• Will it get better or worse?
• What can I do to prevent kidney damage?
• Is this condition genetic?
• Do I need dialysis?

A note from Cleveland Clinic

Many people with glomerulonephritis don’t have symptoms. That’s why it’s important to see a healthcare provider regularly. They can detect when something seems off based on doing examinations and looking at your health history. Some causes of glomerulonephritis are within your control. These include practicing safe sex and seeking medical attention if you believe you have an infection. If you receive a glomerulonephritis diagnosis, treatment depends on the cause and how severe the condition is. Certain strategies can help keep your kidneys healthy and avoid further damage. Be sure to discuss any questions or concerns you have with your provider.