Causes of Glomerulonephritis
Glomerulonephritis has many causes, including infections, autoimmune diseases, and inherited conditions. It develops when the glomeruli—the kidney’s filtering units—become inflamed, which damages kidney function. This inflammation may result from an immune response, direct injury to kidney tissue, or a broader systemic disease.
Understanding the underlying cause is essential for selecting the most effective treatment to prevent long-term kidney damage. In many cases, the root cause determines whether the condition is temporary and treatable or chronic and progressive.
Immune-Mediated Causes
A significant number of glomerulonephritis cases are immune-mediated, meaning the body’s immune system makes the mistake of attacking its own tissues or reacts abnormally to infection.
1. Post-Infectious Glomerulonephritis
Often follows streptococcal infections, such as strep throat or impetigo
More common in children and adolescents
Develops 1 to 3 weeks after infection
Triggered by immune complex deposition in the glomeruli
Other infections that can cause this include:
Hepatitis B and C
HIV
Malaria
Infective endocarditis
Most cases resolve with supportive care, although some may progress to chronic disease.
2. IgA Nephropathy (Berger’s Disease)
One of the most common causes of glomerulonephritis worldwide
Caused by deposits of IgA antibodies in the glomeruli
Leads to recurring blood in the urine, often after upper respiratory infections
Can progress slowly over decades
3. Lupus Nephritis
Occurs in people with systemic lupus erythaematosus (SLE)
Autoantibodies attack the glomeruli
Can lead to proteinuria, haematuria, and kidney failure
Severity ranges from mild to rapidly progressive
4. ANCA-Associated Vasculitis
This group includes granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA).
Because this can worsen fast, treatment needs to start right away with strong medicines that calm down the immune system (immunosuppressive therapy).
These conditions happen when the immune system mistakenly attacks small blood vessels in the body.
As a result, they can quickly damage the kidneys, leading to a serious condition called rapidly progressive glomerulonephritis (RPGN).
Genetic and Hereditary Causes
Some forms of glomerulonephritis are inherited, often manifesting in childhood or adolescence.
1. Alport Syndrome
Caused by cells that mutate too rapidly in the COL4A5 gene, affecting collagen in kidney cell-membranes
Leads to progressive kidney failure
Often associated with hearing loss and eye abnormalities
2. Thin Basement Membrane Disease
Causes microscopic haematuria
Usually benign but may progress to kidney issues in some families
3. Familial FSGS (Focal Segmental Glomerulosclerosis)
Genetic defects in podocyte function
May resist steroid treatment, causing issues.
Can progress to ESRD
Secondary to Systemic Diseases
Glomerulonephritis may develop from issues caused by other illnesses:
1. Diabetes Mellitus
Can lead to diabetic nephropathy, a leading cause of kidney failure
Though not traditionally categorised as glomerulonephritis, similar pathology occurs
2. Goodpasture Syndrome
Autoimmune disorder where antibodies attack both lungs and kidneys
Causes bleeding in the lungs and rapidly progressive kidney failure
Rare but extremely dangerous if untreated
3. Amyloidosis
Abnormal protein deposits in organs, including kidneys
Disrupt glomerular function
Associated with chronic inflammation or blood disorders
Environmental and Lifestyle-Related Causes
Certain environmental factors may trigger glomerulonephritis or exacerbate existing inflammation.
These include:
Prolonged use of NSAIDs (e.g. ibuprofen)
Exposure to heavy metals or toxins
Use of recreational drugs, such as heroin
Poorly controlled high blood pressure
Though not direct causes in most cases, these factors can worsen the kidney damage and cause issues for existing glomerular disease.
Idiopathic Glomerulonephritis
In some cases, no clear cause is identified. These are termed idiopathic glomerulonephritis. They may still be managed effectively with:
Immunosuppressive medications
Lifestyle modifications
Close monitoring to track kidney function
Idiopathic conditions include minimal change disease and idiopathic membranous nephropathy.
Summary of Main Causes
| Cause Type | Examples |
| Post-infectious | Strep throat, hepatitis B/C, HIV |
| Autoimmune | Lupus, ANCA vasculitis, Goodpasture’s |
| Genetic | Alport syndrome, familial FSGS |
| Systemic illness | Diabetes, amyloidosis |
| Environmental/lifestyle | NSAIDs, toxins, drugs |
| Idiopathic | No identifiable cause |
Conclusion | Causes of Glomerulonephritis
The causes of glomerulonephritis are diverse, ranging from infections and autoimmune disorders to inherited conditions. Identifying the specific cause is vital to guide treatment and assess the risk of progression. With early diagnosis and appropriate care, many people with glomerulonephritis can maintain healthy kidney function and avoid serious complications.
