Complications of Glomerulonephritis
The complications of glomerulonephritis can be serious, particularly when diagnosis is delayed or treatment is inadequate. While many cases resolve with minimal long-term damage, others lead to chronic kidney disease, systemic complications, or even kidney failure. Identifying the complications of glomerulonephritis early can prevent life-altering consequences and improve long-term outcomes.
These complications arise as a result of ongoing inflammation, immune dysfunction, or scarring in the kidneys. The severity and likelihood of complications depend on the type of glomerulonephritis, the underlying cause, and how promptly it is managed.
1. Chronic Kidney Disease (CKD)
One of the most common long-term outcomes of glomerulonephritis is chronic kidney disease. Repeated inflammation or ongoing damage to the glomeruli can lead to:
Gradual decline in kidney function
Increased serum creatinine and reduced GFR
Accumulation of waste products in the blood
CKD develops in stages and may remain stable for years if well managed. However, without appropriate treatment, it may eventually progress to kidney failure.
2. End-Stage Renal Disease (ESRD)
If glomerular damage continues unchecked, end-stage renal disease can occur. This is the most severe complication and requires:
Dialysis, either haemodialysis or peritoneal dialysis, to perform the kidney’s filtering role
Kidney transplantation, when suitable
ESRD significantly affects quality of life and life expectancy. It is more common in chronic or severe cases of glomerulonephritis, particularly those resistant to treatment.
3. Nephrotic Syndrome
Several forms of glomerulonephritis can lead to nephrotic syndrome, a condition marked by:
Severe proteinuria
Low blood albumin levels
Generalised oedema
High cholesterol and blood lipid levels
Nephrotic syndrome increases the risk of:
Blood clots (venous thromboembolism)
Infections, due to loss of immunoglobulins
Malnutrition, if protein loss is significant
Early and aggressive treatment can reverse nephrotic syndrome in many cases.
4. Hypertension (High Blood Pressure)
Inflamed or scarred kidneys struggle to regulate fluid and salt, leading to high blood pressure, which in turn accelerates glomerular damage. Complications of uncontrolled hypertension include:
Heart disease
Stroke
Vision loss
Further kidney damage
Managing blood pressure is essential to prevent worsening of glomerulonephritis.
5. Electrolyte and Metabolic Imbalances
Advanced glomerular disease can disrupt electrolyte levels and cause:
Hyperkalaemia (high potassium), increasing the risk of cardiac arrhythmias
Metabolic acidosis, leading to fatigue and bone loss
Calcium and phosphate imbalances, which contribute to bone disease
These imbalances require close monitoring and may need specific medications or dietary adjustments.
6. Anaemia
Reduced kidney function impairs the production of erythropoietin, a hormone required for red blood cell production. This can lead to:
Chronic anaemia
Fatigue, weakness, and reduced concentration
Anaemia of chronic disease is common in later stages and often requires iron supplementation or erythropoiesis-stimulating agents.
7. Cardiovascular Disease
Glomerulonephritis increases the risk of heart disease through several mechanisms:
Hypertension
High cholesterol (especially in nephrotic syndrome)
Inflammation and oxidative stress
Anaemia, which increases cardiac strain
Cardiovascular events are a leading cause of death in people with chronic kidney disease, making prevention vital.
8. Psychological and Quality-of-Life Impacts
Living with chronic illness can result in:
Depression or anxiety
Loss of independence
Work or school disruptions
Financial strain due to medical costs
Early referral to counselling services, social workers, and patient support groups can help mitigate these challenges.
Summary of Common Complications
| Complication | Impact |
| Chronic kidney disease | Gradual loss of kidney function |
| Kidney failure (ESRD) | Requires dialysis or transplant |
| Nephrotic syndrome | Severe protein loss and immune risk |
| Hypertension | Heart disease, stroke, kidney damage |
| Electrolyte imbalances | Bone, heart, and muscle complications |
| Anaemia | Fatigue, reduced productivity |
| Cardiovascular disease | Increased mortality risk |
| Mental health challenges | Depression, anxiety, social impact |
Conclusion | Complications of Glomerulonephritis
The complications of glomerulonephritis can range from manageable metabolic issues to life-threatening kidney failure. However, with early detection, appropriate treatment, and regular follow-up, many of these complications can be avoided or delayed. Addressing the complications of glomerulonephritis proactively not only protects kidney health but also improves overall quality of life and long-term outcomes.
