Glomerulonephritis is inflammation that occurs in the glomerulus, which is the part of the kidney that functions to filter waste products and remove excess fluids and electrolytes from the body. If not treated immediately, severe or prolonged glomerulonephritis can lead to kidney failure.
Glomerulonephritis can occur suddenly (acute) or last a long time (chronic). This condition can also progress rapidly and cause kidney damage ( rapidly progressive glomerulonephritis ).
Glomerulonephritis needs to be treated because it can cause dangerous complications, such as acute kidney failure or chronic kidney failure.
Causes of Glomerulonephritis
Glomerulonephritis can be caused by infection, autoimmune disease , inflammation in blood vessels, or certain diseases. Generally, the cause of acute glomerulonephritis is more obvious than the cause of chronic glomerulonephritis.
Some conditions that can cause acute glomerulonephritis are:
Bacterial or viral infection
Bacterial or viral infections can trigger an overreaction of the immune system, causing inflammation in the kidneys. Examples of infections that can cause glomerulonephritis are Streptococcus infections in the throat, dental infections, bacterial endocarditis , HIV/AIDS, and hepatitis.
vasculitis
Vasculitis can occur in various organs, including the kidneys. Examples of vasculitis that attacks the blood vessels of the kidneys and causes glomerulonephritis are polyarteritis and Wegener's granulomatosis.
Autoimmune disease
Lupus disease is a type of autoimmune disease that can cause inflammation in all organs of the body, including the kidneys and glomerulus. Apart from lupus, several immune system disorders that also cause inflammation of the glomeruli are:
- Goodpasture's syndrome, which is a condition that resembles pneumonia and can cause bleeding in the lungs and kidneys
- IgA nephropathy, which is a condition that causes deposits of one of the proteins that are part of the immune system (IgA) in the glomerulus of the kidney
Another cause
Decreased or worsening kidney function can also be a contributing factor to acute glomerulonephritis. Decreased kidney function generally occurs due to certain diseases or medical conditions, such as:
- High blood pressure (hypertension)
- Diabetic nephropathy
- Rare disease of focal segmental glomerulosclerosis
Meanwhile, the cause of chronic glomerulonephritis is often not known with certainty. One genetic disease, namely Alport syndrome, is thought to cause chronic glomerulonephritis. Exposure to hydrocarbon solvent chemicals and a history of cancer are also thought to trigger chronic glomerulonephritis.
Glomerulonephritis symptoms
Symptoms experienced by sufferers of glomerulonephritis depend on the type of disease, whether acute or chronic. Symptoms that generally appear include:
- Foamy urine
- Bloody urine ( hematuria )
- Swelling of the face, hands, feet or stomach
- The frequency of urination is reduced
- High blood pressure ( hypertension )
Apart from the symptoms above, people with glomerulonephritis can also experience other symptoms, such as:
- Stomach ache
- Vomiting
- Diarrhea
- Rash
- Fever
- Cough
- Hard to breathe
- The body gets tired easily
- Loss of appetite
- Joint and muscle pain
- Nosebleed
Chronic glomerulonephritis is often difficult to detect because it can develop without causing symptoms. When it appears, the symptoms of chronic glomerulonephritis will usually resemble those of an acute one. However, in chronic glomerulonephritis there is an increased frequency of urination at night.
When to see a doctor
Check with your doctor if you experience the symptoms mentioned above. If you suffer from a disease that can cause glomerulonephritis, do regular checkups and follow the treatment given by your doctor.
Diagnosis of glomerulonephritis
The doctor will ask about the patient's symptoms and medical history, then perform a physical examination to see swelling in the limbs or face, and measure the patient's blood pressure .
To make a diagnosis while determining the cause of glomerulonephritis, the doctor will carry out further examinations, including:
- Urine test , to detect the presence of red blood cells, white blood cells, and protein in the urine
- Blood test , to find out whether there is a decrease in hemoglobin ( anemia ) and albumin protein levels, as well as increased levels of waste substances such as urea and creatinine
- Immunological tests, to detect autoimmune diseases by looking for increased levels of antinuclear antibodies (ANA), complement, antineutrophil cytoplasmic antibody (ANCA), or antiglomerular basement membrane (anti-GBM)
- Scanning with X-rays, CT scans, or ultrasound , to see the condition of the kidneys more clearly
- Kidney biopsy (tissue sampling), to detect abnormal tissue and confirm glomerulonephritis
Treatment of glomerulonephritis
Treatment of glomerulonephritis depends on the type suffered (acute or chronic), the cause, and the severity of the symptoms experienced by the patient. The main goal of treating glomerulonephritis is to prevent further kidney damage.
Several methods of treating glomerulonephritis that can be given include:
- Immunosuppressant drugs , to treat glomerulonephritis due to autoimmune diseases, for example corticosteroids , cyclophosphamide, ciclosporin , mycophenolate mofetil, and azathioprine
- Antihypertensive drugs , to prevent further kidney damage due to increased blood pressure, for example are ACE inhibitors ( captropil and lisinopril) and ARBs ( losartan and valsartan )
- Plasmapheresis, which is a method to remove plasma that has destructive properties with healthy plasma
- Diuretics , to relieve swelling experienced by patients
If glomerulonephritis is detected early, kidney damage can be cured. However, if glomerulonephritis gets worse or causes kidney failure, the patient must undergo hemodialysis (dialysis) or kidney transplant surgery .
To prevent kidney damage from getting worse, patients will be advised to maintain an ideal body weight , stop smoking, limit consumption of foods high in potassium , protein and salt, and take calcium supplements.
Glomerulonephritis complications
Acute glomerulonephritis can sometimes heal without specific treatment. However, glomerulonephritis that is not treated properly can get worse and trigger other diseases. Some of the complications that may occur are:
- Hypertension
- High cholesterol
- Nephrotic syndrome
- Acute kidney failure
- Chronic kidney disease or chronic kidney failure
- Heart failure and pulmonary edema , due to accumulation of fluid in the body
- Disorders of sodium and potassium electrolyte balance
- Increased risk of infection
Prevention of glomerulonephritis
Glomerulonephritis is a condition that cannot be completely avoided. However, there are several steps that can be taken to prevent this condition from developing more seriously, namely:
- Immediately undergo a series of treatments if you have a bacterial infection in certain parts of the body, such as a sore throat or impetigo .
- Always practice safe sex and avoid using injecting drugs to prevent transmission of viral infections that can trigger glomerulonephritis.
- Control blood pressure regularly, to avoid kidney damage due to high blood pressure.
- Perform regular blood sugar control, to prevent diabetic nephropathy.