Glomerulonephritis (GN)

Overview

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. If the condition becomes severe, it can lead to kidney failure. Healthcare providers abbreviate glomerulonephritis as GN and sometimes call it glomerular disease.

How do glomeruli help your kidneys?

Glomeruli are filtering units made of capillaries (tiny blood vessels) in the kidneys. They filter the blood and remove waste and extra fluid from the blood — the first step as the body makes urine (pee).

Are there different types of glomerulonephritis?

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

Symptoms and Causes

What causes glomerulonephritis (GN)?

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

  • Genetics, meaning it runs in the family (this is rare).
  • Anti-GBM disease (formerly Goodpasture syndrome), a group of diseases affecting the lungs and kidneys.
  • Secondary to endocarditis, an infection in the heart valves.
  • Secondary to other viral infections, such as strep throat, HIV or hepatitis C.
  • Problems with the immune system attacking healthy parts of the body, such as with lupus.
  • 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-Srauss Syndrome).

What are the symptoms of glomerulonephritis?

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

  • Blood in the urine, which may make the pee look brown, pink or red.
  • Fatigue, nausea or a rash.
  • Hypertension (high blood pressure) or shortness of breath.
  • Pain in the joints or abdomen (belly area).
  • Peeing less often or more often than normal.
  • Swelling in the legs or face.
  • Urine that’s foamy.

If you have one or more of these symptoms, contact a healthcare provider.

Diagnosis and Tests

How is glomerulonephritis diagnosed?

Glomerulonephritis may not produce symptoms. That’s why it’s often discovered during tests for another problem. If a healthcare provider suspects you have glomerulonephritis, 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 (waste product filtered by the kidneys) in a sample of your blood.
  • Kidney biopsy: For a kidney biopsy, a healthcare provider will use a needle to remove a tiny piece of kidney tissue. The tissue gets examined under a microscope.
  • Ultrasound: An ultrasound checks the size of your kidneys, looks for blockages and identifies any problems.

Management and Treatment

How is glomerulonephritis treated?

Treatment depends on what caused the glomerulonephritis and the damage done to the kidney filters. A mild case may not need any treatment. At other times, your healthcare provider may recommend:

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

Prevention

Can I prevent glomerulonephritis?

There is no proven way to prevent glomerulonephritis, though some practices may help:

  • Eat a healthy, unprocessed food.
  • Manage high blood pressure with a low salt diet, exercise and medication.
  • Prevent infections by practicing good hygiene and safe sex. Also avoid using needles for illegal drugs and tattoos.
  • See a healthcare provider whenever you think you have an infection like strep throat.

Outlook / Prognosis

What is the outlook for people with glomerulonephritis?

Different people have different outcomes with glomerulonephritis. Some cases go away without any treatment. Some people find that treatment improves or maintains kidney function. But others may develop long-term health problems such as:

  • Blood clots, including deep vein thrombosis (DVT) or pulmonary embolism (PE).
  • Chronic kidney disease.
  • Hypertension (high blood pressure).
  • High cholesterol.
  • Kidney failure, quickly or after several years.
  • Nephritic syndrome, with red blood cells leaking into urine and making it look red or brown.
  • Nephrotic syndrome (nephrosis), with protein in the urine often leading to foamy urine and swelling in the body.

Living With

How can I manage glomerulonephritis?

If you have glomerulonephritis, get your kidneys checked on a regular basis. Follow medical advice and take prescriptions (if needed) to manage the cause. You also may have to limit the amount of salt, protein and potassium you eat. Doing so can ease the stress on your kidneys.

What else can I ask my healthcare provider?

Consider asking your healthcare provider:

  • What is causing the glomerulonephritis?
  • Can you treat the cause?
  • What is my kidney function right now?
  • Will it get better or worse?
  • What can I do to prevent kidney damage?
  • Is this condition genetic?

A note from Cleveland Clinic

Anytime you think you have an infection, seek medical attention. Infections are a common cause of glomerulonephritis. If you have the condition, you may notice that your pee is foamy or a different color. Treatment depends on the cause and how bad the condition is. Certain strategies can help keep your kidneys healthy and avoid kidney failure.

Last reviewed by a Cleveland Clinic medical professional on 11/04/2020.

References

  • American Kidney Fund. Glomerulonephritis. (https://www.kidneyfund.org/kidney-disease/other-kidney-conditions/rare-diseases/glomerulonephritis/) Accessed 11/3/2020.
  • National Health Service. Glomerulonephritis. (https://www.nhs.uk/conditions/glomerulonephritis/) Accessed 11/3/2020.
  • National Health Service. Treatment: Glomerulonephritis. (https://www.nhs.uk/conditions/glomerulonephritis/treatment/) Accessed 11/3/2020.
  • National Kidney Foundation. Glomerulonephritis. (https://www.kidney.org/atoz/content/glomerul) Accessed 11/3/2020.

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