Dr. M.J. Bazos, MD Patient Handout

GLOMERULONEPHRITIS


About Your Diagnosis
Glomerulonephritis is the term used to describe a group of diseases that cause inflammation of the part of the kidney that filters blood. The inflammation in turn causes damage to the kidney, and it cannot get rid of the waste products and extra fluid in the body. Sometimes the kidneys may stop working completely. There are two forms of this condition, acute and chronic. The acute form develops suddenly, whereas the chronic form may develop silently over many years. You may get acute glomerulonephritis after an infection in your throat or skin, although this is not always the case. It may also be caused by some other illnesses, including lupus, Goodpasture’s syndrome, Wegener’s granulomatosis, Henoch-Schönlein purpura, and polyarteritis nodosa. On the other hand, in many cases of chronic glomerulonephritis the cause is not known. In some cases the disease runs in the family. This kind shows up in young men who also have associated hearing loss. Some forms are caused by immune system changes. An episode of acute glomerulonephritis may be followed by chronic disease years later. The diagnosis is made by clues from your history. Urine showing protein and blood cells is a further clue. Blood tests help your doctor determine the cause of your glomerulonephritis in some cases, as well as how much your kidneys have been damaged. Sometimes your doctor will need to do a kidney biopsy (take a tiny piece of your kidney with a special needle) to help determine the best form of treatment.

Living With Your Diagnosis
With acute glomerulonephritis, you will feel ill and go to the bathroom less often. Your urine is red, smoky, or rusty because blood is in it. Your face, eyelids, and hands may be swollen in the morning, and your ankles may be puffy in the evening. You may be short of breath and cough because of extra fluid in your lungs. Your blood pressure may be high. One or all of these symptoms may be present. With chronic glomerulonephritis, you may have long periods with no symptoms, but your kidneys are still being damaged. You may have protein and blood in your urine as the only sign. As the disease worsens, you have symptoms such as swelling of your face and ankles, loss of appetite, vomiting, and feeling very tired. Your skin may become dry and itchy, and you may have muscle cramps at night.

Treatment
Occasionally the glomerulonephritis may not need any treatment and go away by itself. Sometimes you may need high doses of medicines that affect your immune system, or you may need to have a special blood filtering process called plasmapheresis. Antibiotics may be used for treatment of infection that may in turn have caused the glomerulonephritis. Temporary treatment with an artificial kidney machine may be required for removal of extra fluid and poisons that build up in the body with glomerulonephritis. There is no specific treatment for the chronic form of the disease. Your doctor may ask you to eat less protein, salt, and potassium, and to take blood pressure pills and calcium supplements.

The DOs
• Good hygiene, “safe sex,” and avoiding intravenous drugs are helpful in preventing infections that could lead to this type of illness.
• Do follow dietary advice because it is very important in preventing complications from your disease.
• Do keep to the fluid restriction you have been advised because otherwise you could have fluid build up in your lungs. This could be dangerous to your immediate health.
• If you have the chronic type of glomerulonephritis, it is very important to control your blood pressure; it is the single most important thing that may slow down kidney damage. Therefore do take your blood pressure medicine regularly.
• Do exercise within your capacity to do so.
The DON’Ts
• Don’t stop taking your medication before checking with your doctor.
• Don’t take over-the-counter medication unless you have checked it with your doctor. Some medicines may not be safe with your kidney condition.
• Don’t take any herbal preparations that you may find at health food stores. Some of these preparations have been known to cause kidney disease.
• Don’t hesitate to ask your doctor any questions about your disease or any concerns about the treatment that you may have.
When to Call Your Doctor
• Always call your doctor if you feel unwell. He may be able to assess whether you need to be seen right away or whether a change in medication is necessary.