Glomerulonephritis
Glomerulonephritis is a group of kidney conditions characterised by inflammation of the glomeruli, the tiny filtering units within the kidneys. These glomeruli remove waste, excess fluid, and toxins from the blood, producing urine. When damaged, the filtration process is disrupted, which can lead to protein and blood leaking into the urine. If glomerulonephritis is left untreated, it can progress to chronic kidney disease or even kidney failure.
The condition can develop suddenly (acute) or gradually over time (chronic), and its severity varies significantly depending on the cause and how quickly it is identified. Prompt diagnosis and appropriate treatment are crucial to preserving kidney function and preventing long-term complications.
Understanding the Glomeruli
The kidneys contain approximately one million glomeruli each. These tiny capillary networks play a vital role in filtering blood, retaining essential proteins, and excreting waste. When glomeruli become inflamed or scarred, their ability to filter properly is impaired, which can lead to:
Haematuria (blood in the urine)
Proteinuria (excess protein in the urine)
Reduced glomerular filtration rate (GFR)
Fluid retention, causing swelling in various parts of the body
In severe cases, the build-up of toxins and fluid imbalances can lead to high blood pressure, fatigue, and systemic complications.
Types of Glomerulonephritis
Glomerulonephritis is not a single disease but a spectrum of related conditions. It is typically classified into:
1. Acute Glomerulonephritis
Develops rapidly over days or weeks
Often follows an infection, such as strep throat or skin infections
Symptoms include dark urine, puffiness around the eyes, and reduced urine output
Can resolve spontaneously or progress to more serious kidney damage
2. Chronic Glomerulonephritis
Develops gradually over months or years
May be asymptomatic in the early stages
Can lead to progressive loss of kidney function and end-stage kidney disease
3. Primary Glomerulonephritis
The kidney is the main organ affected
Includes diseases like minimal change disease, focal segmental glomerulosclerosis (FSGS), and IgA nephropathy
4. Secondary Glomerulonephritis
Occurs as part of a systemic condition, such as:
Lupus
Diabetes
Vasculitis
Hepatitis B or C
HIV
Who Is at Risk?
Glomerulonephritis can affect people of all ages, but certain groups face a higher risk:
Children and young adults: More likely to develop acute forms after infections
People with autoimmune diseases: Higher risk of chronic or secondary forms
Individuals with a family history of kidney disorders
People with diabetes, lupus, or viral infections
Some forms are more prevalent in specific populations—for instance, FSGS is more common in people of African descent.
Common Symptoms
Symptoms vary depending on the type and severity but may include:
Foamy or bubbly urine (due to protein loss)
Blood in the urine, which may appear pink, red, or cola-coloured
High blood pressure
Swelling, particularly in the face, hands, feet, and abdomen
Fatigue and weakness
Decreased urination
Unexplained weight gain from fluid retention
In mild cases, symptoms may be subtle or entirely absent, making routine screening important for those at risk.
Diagnosis
Early and accurate diagnosis is essential for managing glomerulonephritis. A full workup typically includes:
Urinalysis to detect blood, protein, and other abnormalities
Blood tests to measure kidney function (e.g., creatinine, urea, GFR)
Serological tests to identify autoimmune or infectious causes
Imaging (such as ultrasound) to assess kidney size and structure
Kidney biopsy for definitive diagnosis in unclear or severe cases
A biopsy helps determine the specific type and extent of glomerular damage, guiding treatment decisions.
Complications
Untreated or poorly managed glomerulonephritis can lead to:
Chronic kidney disease (CKD)
End-stage renal disease (ESRD) requiring dialysis or transplant
Nephrotic syndrome (high protein loss, low albumin, swelling)
High blood pressure
Electrolyte imbalances, such as high potassium
Anaemia
The prognosis depends on early detection, the underlying cause, and the individual’s response to treatment.
Living with Glomerulonephritis
People diagnosed with glomerulonephritis should work closely with a nephrologist. Management often includes:
Regular monitoring of kidney function
Blood pressure control
Dietary modifications, such as reduced salt and protein intake
Avoiding nephrotoxic medications, including NSAIDs
Adherence to prescribed medication regimens
With appropriate care, many patients can maintain stable kidney function and live normal lives.
Conclusion of Glomerulonephritis
Glomerulonephritis is a serious but manageable condition when caught early. By understanding the signs and seeking timely medical advice, individuals can protect their kidneys and prevent irreversible damage. With the right treatment and lifestyle changes, long-term outcomes are often positive.
