Glomerulonephritis

Overview

Glomerulonephritis
Glomerulonephritis

Glomerulonephritis is damage to the tiny filters inside your kidneys (the glomeruli). It's often caused by your immune system attacking healthy body tissue.

Glomerulonephritis doesn't usually cause any noticeable symptoms. It's more likely to be diagnosed when blood or urine tests are carried out for another reason.

Although mild cases of glomerulonephritis can be treated effectively, for some people the condition can lead to long-term kidney problems.

Symptoms of glomerulonephritis

In severe cases of glomerulonephritis, you may see blood in your urine. However, this is usually noticed when a urine sample is tested.

Your urine may be frothy if it contains a large amount of protein.

If a lot of protein leaks into your urine, swelling of the legs or other parts of the body can also develop. This is known as nephrotic syndrome.

Depending on your type of glomerulonephritis, other parts of your body can be affected and cause symptoms such as:

  • rashes
  • joint pain
  • stomach pain
  • high temperature
  • shortness of breath
  • yellowing of the whites of the eyes or the skin, although this may be less noticeable on brown or black skin (jaundice)
  • peeing a lot less than usual
  • tiredness
  • loss of appetite and weight loss

Some people with glomerulonephritis also have high blood pressure.

When to get medical advice

See your GP if you notice blood in your urine. This doesn't always mean you have glomerulonephritis, but the cause should be investigated.

Also see a GP if you have other symptoms of glomerulonephritis, such as pain in your joints, tiredness and shortness of breath.

If the GP suspects glomerulonephritis, they'll usually arrange:

  • blood tests – to check how much protein is in your blood and measure your creatinine level (creatinine is a waste product produced by your muscles)
  • a urine test – to check for blood or protein in your pee

If you do have glomerulonephritis, further blood tests may be needed to help find out the cause.

If your kidney problem needs to be investigated further, other tests may be recommended, including:

  • an ultrasound scan – this is to check the size of your kidneys, make sure there are no blockages, and look for any other problems
  • biopsy – this is to remove a small sample of kidney tissue, carried out using local anaesthetic to numb the area; an ultrasound machine locates your kidneys and a small needle is used to take a sample

Causes of glomerulonephritis

Glomerulonephritis often happens if there's a problem with your immune system. It can be caused by inflammatory conditions like systemic lupus erythematosus (SLE) or vasculitis.

In some cases, the immune system abnormalities are triggered by an infection, such as:

Some types of cancer and certain medicines can also cause glomerulonephritis.

Sometimes it’s not clear what causes it.

If you're diagnosed with an inherited type of glomerulonephritis, a doctor can advise you about the chances of someone else in your family being affected.

They may recommend screening, which can identify people who may be at increased risk of developing the condition.

Treating glomerulonephritis

Treatment for glomerulonephritis depends on the cause and severity of your condition. If an underlying condition can be identified, treating it can help.

Treatment can be as simple as making changes to your diet, such as eating less salt to reduce the strain on your kidneys.

Medicine to lower blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors, is commonly prescribed because it helps protect the kidneys.

If the condition is caused by a problem with your immune system, medicine called immunosuppressants may be used.

Complications of glomerulonephritis

Although treatment for glomerulonephritis is effective in many cases, further problems can sometimes develop.

These include:

If you're diagnosed with glomerulonephritis, your doctor may prescribe medicine to help lower your blood pressure, lower your cholesterol or protect against blood clots.

Treatment

Treatment for glomerulonephritis depends on what's causing it and your symptoms.

If you have severe glomerulonephritis, you’ll usually be referred to a kidney specialist (nephrologist) for treatment).

Dietary changes

In mild cases, your GP or dietitian will give you relevant advice about diet. 

You may be advised to:

  • reduce the amount of salt, fat, protein and potassium in your diet
  • drink less fluid

This should help control your blood pressure and ensure the amount of fluid in your body is regulated.

You should have regular reviews to check your blood pressure, the levels of salt and potassium in your pee and how well your kidneys are working.

Stopping smoking

Smoking may make kidney disease caused by glomerulonephritis worse.

It also increases the risk of complications like heart disease and stroke, which are more common in people with glomerulonephritis.

Find out more about stopping smoking.

Immunosuppressants

If glomerulonephritis is caused by problems with your immune system, medicines called immunosuppressants may be recommended. These medicines suppress your immune system.

Suppressing your immune system can be effective, but it also increases your risk of infections and can cause other side effects, such as thinning of the bones (osteoporosis)

If you're offered treatment with immunosuppressant medicines, they'll be adjusted to the level needed to treat your condition and will be carefully monitored.

Steroids

You may be put on a course of medicines containing steroids, such as prednisolone.

Steroids are used to reduce swelling and suppress your immune system.

Once your kidneys have started to recover, your dose of steroids will usually be lowered. You may continue to take a small dose, or this treatment may be stopped altogether.

Other medicines

If you take immunosuppressants or steroids to suppress your immune system, you may also be given medicines to help prevent side effects such as infections and osteoporosis.

If your condition is thought to be linked to a viral infection, it may be treated with antiviral medicine.

Individual symptoms can sometimes be treated. For example, swelling caused by a build-up of fluid may be treated with a type of medicine called a diuretic.

Treating high blood pressure

Glomerulonephritis often leads to high blood pressure, which can cause further kidney damage and other health problems.

Your blood pressure will be carefully monitored by the healthcare professionals treating you.

You may need to take medicines that lower blood pressure and help reduce the amount of protein that leaks into your urine, such as either:

  • an angiotensin-converting enzyme (ACE) inhibitor
  • an angiotensin receptor blockers (ARB)

Often, people who have high blood pressure and kidney disease need to take several medicines to control their blood pressure.

These medicines are commonly prescribed, even if your blood pressure is not particularly high, as they can help protect your kidneys.

Read more about treating high blood pressure.

Treating high cholesterol

High cholesterol levels are common in people with glomerulonephritis.

A doctor may recommend medicine to reduce cholesterol and help protect you against complications such as heart and vascular disease. Statins are the most frequently used medicine.

Read more about medicines for high cholesterol.

Plasma exchange

Plasma is a fluid that is part of the blood. It contains proteins that can make your kidneys inflamed.

Plasma exchange involves removing some of the plasma from your blood.

During the procedure, you're connected to a machine that gradually removes some of your blood.

The plasma is separated from the blood cells and removed. A plasma substitute is then added to the blood before it's put back into your body.

Plasma exchange may be used in certain circumstances if your condition is severe.

Treating chronic kidney disease or kidney failure

If you have severe glomerulonephritis that cannot be improved with other treatments, you may require:

  • kidney dialysis – a treatment that takes over part of the kidney's job and removes waste products from your body
  • a kidney transplant – where a healthy kidney from a donor is surgically implanted to replace your own kidney

Vaccinations

As glomerulonephritis can make you more vulnerable to infections, it's a good idea to protect yourself by having a seasonal flu vaccine and a pneumonia vaccine (also called the pneumococcal vaccine).



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 11/12/2024 14:48:16