Glomerulonephritis Treatment in Delhi, India

Glomerulonephritis, also called nephritis (GN), is an inflammation of the glomeruli, which are small structures present in the kidneys and made up of tiny blood vessels. These knots of vessels help filter blood, remove excess fluids, electrolytes, and waste products from the bloodstream and proceed them into the urine. If the glomeruli are damaged, kidneys will stop working correctly, ultimately resulting in kidney failure.

There are two main types of glomerulonephritis.

• Acute Glomerulonephritis: A sudden onset of kidney inflammation often caused by infection but can also occur due to autoimmune disorders etc.
• Chronic Glomerulonephritis: Nearly all forms of acute glomerulonephritis can progress to chronic glomerulonephritis depending on the underlying cause. Important causes include primary glomerular diseases (like FSGS, MPGN, Membranous nephropathy, etc), autoimmune conditions (like lupus nephritis, ANCA-related vasculitis, etc.), certain infections and medications.

It is important to note that some people can have an acute attack of glomerulonephritis and then develop chronic glomerulonephritis years later.

The various signs and symptoms linked with Glomerulonephritis have been divided into the following three stages.

Symptoms of Acute Glomerulonephritis

The early signs and symptoms of acute glomerulonephritis include:

• Puffiness in the facial area
• Decrease in urine output
• Cola coloured/red urine
• Extra fluid in the lungs causes coughing
• High blood pressure levels

Symptoms of Chronic Glomerulonephritis

The chronic form of nephritis can crop up without any significant symptoms. Some of the peculiar symptoms comprise:

• Swelling around ankles and face
• Frequent urination during the night
• Bubbly or foamy urine from excess protein
• High blood pressure levels
• Simple urine tests may show the presence of protein, red blood cells

Symptoms of Kidney Failure

While most patients with acute glomerulonephritis may present with symptoms as described above, many patients with chronic glomerulonephritis may be relatively free of any symptoms, even when kidney function has declined significantly.

• Lack of appetite
• Nausea or vomiting
• Fatigue, insomnia
• Dry, itchy skin
• Swelling of face, feet, or body
• Decreased urine output
• Shortness of breath

There are many that cause glomerulonephritis. Sometimes, the disease runs in families and has a genetic factor involved, whereas in other cases, the cause of glomerulonephritis is completely unknown. Conditions that can lead to glomerulonephritis include:

A- Infections

• Post-streptococcal Glomerulonephritis: Glomerulonephritis may develop in a patient around two to three weeks post-recovery from a throat infection or, rarely, a skin infection called impetigo. To fight against the infection, the body produces antibodies that accumulate in the glomeruli, causing inflammation. Children are more prone to develop post-streptococcal glomerulonephritis than adults, and they're also more likely to recover quickly.
• Bacterial Endocarditis: Occasionally, the bacteria can spread through the bloodstream and accumulate in the heart, causing an infection of one or more heart valves. Patients with a heart defect, such as a damaged or artificial heart valve, are at a greater risk of developing this condition.
• Viral infections: Certain viral infections, HIV, hepatitis B, and hepatitis C, can end up provoking glomerulonephritis.

B- Immune diseases

• Lupus: Being a chronic inflammatory disease, this can influence several parts of the body, including skin, joints, kidneys, blood cells, heart, and lungs.
• Goodpasture's syndrome: A rare immunological disorder due to an abnormal antibody, which can partially damage kidneys and lungs.

C- Primary Glomerular Diseases

• IgA nephropathy: This primary glomerular disease results from the deposition of immunoglobulin A (IgA) in the glomeruli. It is the most common primary glomerular disease. 
• Others include FSGS, MPGN, membraneous nephropathy, etc.

D- Vasculitis

• Granulomatosis with polyangiitis: This affects small and medium blood vessels in the area of the lungs, upper airways, and kidneys.

E- Other cases

In addition to the mentioned cases above, glomerulonephritis is associated with certain types of cancers, such as multiple myeloma, lung cancer, and chronic lymphocytic leukaemia (CLL).

There are a number of risk factors that can increase the chances of developing glomerulonephritis, including:

• Having a family history of kidney disease
• Having an autoimmune condition, such as lupus or rheumatoid arthritis
• Viral infections, such as strep throat or hepatitis B
• Taking certain medications, such as antibiotics or blood pressure medications
• Being exposed to certain toxins, such as lead or mercury
• Certain medications, like gold etc

Glomerulonephritis is suspected during the early phases when a routine urinalysis examination is abnormal. In the context of clinical assessment of any given patient.

• Urine test:A urinalysis might show the presence of protein in red blood cells and red cell casts in a urine sample, which is an indicator of possible damage to the glomeruli. 
• Blood tests: These can reveal information about possible kidney damage and glomerular impairment by measurement of creatinine and blood urea nitrogen.
• Imaging tests: If the doctor detects evidence of damage, they may advise diagnostic studies that allow visualisation of kidneys as detected by an ultrasound or a CT scan.
• Kidney biopsy: This procedure uses a special needle to extract small pieces of kidney tissue for microscopic examination to determine the cause of the inflammation. A kidney biopsy is almost always necessary to confirm a diagnosis of glomerulonephritis.

Treatment for Glomerulonephritis depends on the underlying causes and the damage levels to the glomeruli. Patients with mild symptoms may not require any treatment.

In other cases, the doctor may recommend the following Glomerulonephritis treatments:

• Dietary changes such as less intake of salt and potassium.
• Medications to lower BP (if needed)
• Diuretics to decrease swelling.
• Corticosteroids
• Dialysis to clear blood, remove extra fluid
• Plasmapheresis may be needed for some diseases

There are no specific means to prevent the occurrence of glomerulonephritis, although certain practices may surely benefit:

• Intake of a healthy and unprocessed diet.
• Management of high blood pressure with a low salt diet, exercise and medication.
• Prevent infections by practising good hygiene and safe sex. Also, avoid using needles for illegal drugs and tattoos.
• Control your blood sugar to help prevent diabetic nephropathy.

The following complications can also occur due to glomerulonephritis:

• Acute kidney injury
• Chronic kidney disease
• Electrolyte imbalance, such as high levels of sodium or potassium
• Congestive heart failure due to retained fluid or fluid overload
• Pulmonary oedema due to retained fluid or fluid overload
• High blood pressure
• Malignant hypertension, which is rapidly increasing high blood pressure
• Increased risk of infections

If caught early, acute Glomerulonephritis can be temporary and reversible. Chronic Glomerulonephritis may be slowed with early treatment. If Glomerulonephritis worsens, it can lead to reduced kidney function, chronic kidney failure, and end-stage renal disease.

If individuals experience persistent kidney-related symptoms such as blood in their urine, changes in urinary habits, unexplained kidney pain, or leg and ankle swelling, prompt consultation with a kidney specialist is vital. 

At Max Hospitals, we emphasise the importance of early intervention. For patients diagnosed with or at risk of chronic kidney disease (CKD) due to factors like diabetes, high blood pressure, or a family history of kidney issues, establishing regular contact with a kidney specialist is essential. This proactive approach ensures effective management and continuous monitoring of kidney function. 

Max Hospitals also recommends consulting kidney specialists for recurrent kidney stones, abnormal kidney function test results, uncontrolled high blood pressure affecting the kidneys, diabetes-related kidney risks, medication concerns, and family history of kidney disease.

How do glomeruli help your kidneys?

Glomeruli are small clusters of blood vessels in the kidneys that filter waste and excess substances from the blood, allowing the kidneys to form urine and maintain overall body fluid balance.

How can I manage glomerulonephritis?

Management of glomerulonephritis typically involves treating the underlying cause, managing symptoms, and controlling blood pressure and proteinuria. This may include medications, dietary changes, and lifestyle modifications.

What is the best treatment for glomerulonephritis?

The treatment for glomerulonephritis depends on the specific type and cause of the condition. It may involve medications, such as corticosteroids or immunosuppressants, lifestyle changes, and managing underlying health issues.

Is glomerulonephritis curable?

The curability of glomerulonephritis depends on the underlying cause and type. Some forms may be curable when the underlying condition is treated, while others may be managed but not entirely cured.

What is the most common cause of primary glomerulonephritis?

The most common cause of primary glomerulonephritis is IgA nephropathy, a condition where the immune system deposits IgA antibodies in the glomeruli, leading to inflammation and kidney damage.

What is an indicator of glomerulonephritis?

Common indicators of glomerulonephritis include hematuria (blood in the urine), proteinuria (excess protein in the urine), edema (swelling), high blood pressure, and decreased kidney function.

What complications does glomerulonephritis cause?

Glomerulonephritis is primarily a kidney condition. It can lead to kidney damage, kidney failure, and various complications related to impaired kidney function.

What are the most common causes of glomerular disease?

Glomerular diseases can be caused by a variety of factors, including infections, autoimmune conditions, systemic diseases, genetic factors, and drug reactions. IgA nephropathy, lupus nephritis, and diabetic nephropathy are some common examples of glomerular diseases.