Treatment of Glomerulonephritis
The treatment of glomerulonephritis depends on the type, underlying cause, and severity of kidney involvement. In many cases, especially with mild or early disease, the treatment of glomerulonephritis focuses on managing symptoms, controlling blood pressure, and reducing inflammation to preserve kidney function. When an autoimmune disorder, infection, or genetic factor causes the condition, doctors must also treat the underlying cause to prevent progression.
Tailoring treatment to the specific type of glomerulonephritis is essential. What works for one form may be inappropriate—or even harmful—for another. The goal is always the same: to protect the glomeruli from further damage and slow or prevent the onset of chronic kidney disease or renal failure.
General Principles of Management
Regardless of the underlying cause, doctors use several treatment approaches in most cases, including:
1. Blood Pressure Control
High blood pressure accelerates glomerular damage, so effective management is critical. Doctors usually prescribe:
ACE inhibitors or angiotensin receptor blockers (ARBs), which reduce both blood pressure and protein loss in the urine
Lifestyle changes like low-sodium diets, weight loss, and regular exercise
Doctors may use these medications to reduce proteinuria and protect kidney health, even in patients with normal blood pressure.
2. Dietary Adjustments
Special dietary recommendations support kidney function and reduce strain on the glomeruli:
Low-protein diet may be advised in some cases to reduce urea build-up
Low-sodium diet to help control blood pressure and reduce oedema
Restricted potassium or phosphorus intake in more advanced disease
Adequate fluid intake to maintain hydration without overloading the kidneys
Dieticians often work alongside nephrologists to personalise nutrition plans.
3. Diuretics
If fluid retention is causing significant swelling, diuretics (such as furosemide) may be used to help the body eliminate excess fluid and reduce oedema.
Treating the Underlying Cause
The cornerstone of effective therapy is addressing the trigger behind the inflammation.
1. Infection-Related Glomerulonephritis
Often self-limiting, particularly in children
Antibiotics may be used if an active infection is still present
Supportive care (rest, blood pressure control) is often sufficient
Immunosuppressive drugs are generally avoided unless complications arise
2. Autoimmune or Immune-Mediated Types
For conditions like lupus nephritis, IgA nephropathy, or ANCA-associated vasculitis, immunosuppressive therapy may be required:
Corticosteroids (e.g. prednisone) to reduce inflammation
Cyclophosphamide, azathioprine, or mycophenolate mofetil as steroid-sparing agents
Rituximab for certain forms of vasculitis or resistant disease
Close monitoring of immune markers, kidney function, and side effects is essential
Immunosuppressive drugs can increase infection risk and require careful management.
3. Nephrotic Syndrome
For nephrotic-range proteinuria, treatment focuses on:
Controlling oedema with diuretics and salt restriction
Reducing protein loss using ACE inhibitors or ARBs
Lowering cholesterol, often with statins
Corticosteroids or immunosuppressants depending on the underlying cause (e.g. minimal change disease, membranous nephropathy)
Plasmapheresis and Advanced Therapies
In rapidly progressive or life-threatening cases, such as Goodpasture syndrome or severe ANCA vasculitis, more aggressive measures may be used:
Plasmapheresis (plasma exchange) to remove harmful antibodies
Combined with high-dose steroids and immunosuppressants
Used in hospital under specialist care
These treatments are reserved for severe cases and require close monitoring in a renal or intensive care setting.
Management of Chronic Glomerulonephritis
For chronic forms, the emphasis is on slowing progression and preventing complications:
Regular monitoring of kidney function, urine protein levels, and blood pressure
Early detection of declining kidney function allows for preemptive planning
Managing comorbidities like diabetes, anaemia, and cardiovascular disease
In advanced stages, patients may need:
Erythropoietin-stimulating agents to treat anaemia
Phosphate binders or vitamin D supplements
Dialysis or consideration for kidney transplant if kidney failure develops
Patient Education and Lifestyle
Empowering patients is a key part of managing glomerulonephritis:
Understanding medication regimens
Learning to monitor blood pressure at home
Attending all scheduled blood and urine tests
Avoiding non-prescribed NSAIDs or nephrotoxic drugs
Vaccination against influenza, hepatitis B, and pneumococcus
Education helps reduce hospitalisation rates and supports long-term kidney health.
Conclusion | Treatment of Glomerulonephritis
The treatment of glomerulonephritis is complex but often highly effective when tailored to the specific cause. Whether it involves immune suppression, infection control, or supportive care, the treatment of glomerulonephritis can slow progression, preserve function, and improve quality of life. Early diagnosis, consistent follow-up, and proactive patient involvement are the keys to successful outcomes.
