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glomerulonephritis INFLAMMATIONof the glome-
ruli within the nephrons of the KIDNEYS. The
glomerulus is the coiled capillary network through
which BLOOD circulates for filtration. Glomeru-
lonephritis, also called glomerular disease, may be
acute (come on suddenly) or chronic (develop
slowly over time). Acute glomerulonephritis is
often a temporary condition that improves with
treatment and causes minimal or no residual dam-
age to the glomeruli. Chronic glomerulonephritis
tends to be progressive, eventually deteriorating to
RENAL FAILUREand END-STAGE RENAL DISEASE(ESRD).
INFECTION, AUTOIMMUNE DISORDERS, NEPHROPATHYof
DIABETES, and nephropathy of HYPERTENSION(high
BLOOD PRESSURE) are the most common identified
causes of glomerulonephritis. As often as not,
however, the nephrologist cannot determine the
cause and focuses instead on treatment.

Symptoms and Diagnostic Path
The symptoms of glomerulonephritis may be min-
imal and difficult to detect or obvious and debili-
tating, depending on whether the condition is
chronic or acute. Common symptoms of glomeru-
lonephritis include

• fatigue


• edema (swelling or puffiness) of the face, hands
  and wrists, and feet and ankles


• discolored URINE(commonly described as tea-
  colored or cola-colored)


• hypertension


• foamy urine (ALBUMINURIA)

The diagnostic path begins with urinalysis,
which typically reveals HEMATURIA (blood in the
urine) and albuminuria (excessive ALBUMIN, or

protein, in the urine). In many people, urinalysis

done as part of aROUTINE MEDICAL EXAMINATIONpro-

vides the first indication of glomerulonephritis.

Blood tests help the nephrologist assess the ability

of the kidneys to remove toxins and wastes from

the blood. Imaging procedures such as abdominal

ULTRASOUNDor COMPUTED TOMOGRAPHY(CT) SCANcan

show the damage to the glomeruli. Needle biopsy

of the kidney tissue allows microscopic examina-

tion of the glomeruli, providing the definitive

diagnosis.

Treatment Options and Outlook

Treatment targets either the underlying condition

or the resulting symptoms. Because hypertension

is nearly always either a cause or a consequence

of glomerulonephritis, the doctor is likely to pre-

scribe medications that lower blood pressure

(antihypertensives) such as beta blockers,

angiotensin-converting enzyme (ACE) inhibitors,

or calcium channel blockers. The doctor may also

prescribe medications to extract more water from

the blood (diuretics), which lowers blood pressure

as well as eases the workload of the kidneys. Bac-

terial infections require ANTIBIOTIC MEDICATIONS.

Viral infections, which are fairly common, will run

their course after which kidney function usually

returns to normal.

Acute glomerulonephritis may result in renal

failure, requiring short-term RENAL DIALYSIS to

remove wastes and toxins from the blood until

kidney function returns enough to resume this

functions. CORTICOSTEROID MEDICATIONS and other

immunosuppressive therapies are necessary when

the cause of the glomerulonephritis is an autoim-

mune disorder. Once the cause of the inflammation

resolves, the glomerulonephritis generally resolves

as well, and kidney function returns to normal.

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