Glomerulonephritis is inflammation of the glomerulus. Glomerulus is the part of the kidney that functions to filter waste and remove excess fluid and electrolytes from the body.
Glomerulonephritis can be short term (acute) or long term (chronic). This condition can also develop quickly and cause kidney damage (rapidly progressive glomerulonephritis).
Glomerulonephritis is a condition that can be caused by infection, autoimmune disease, or inflammation of the blood vessels. This condition needs to be treated because it can cause complications, such as acute kidney failure or chronic kidney failure.
Glomerulonephritis Causes and Trigger Factors
Glomerulonephritis can occur due to various conditions, such as infections, autoimmune diseases, and blood vessel disorders. Generally, acute glomerulonephritis has a more obvious cause than chronic glomerulonephritis.
Some of the conditions that can cause acute glomerulonephritis are:
Bacterial or viral infection
Bacterial or viral infections can trigger an overreaction of the body's immune system, resulting in inflammation of the kidneys. Examples of infections that can cause glomerulonephritis are bacterial infections Streptococcus in the throat, tooth infection,endocarditis bacteria, HIV, and hepatitis.
Vasculitis
Vasculitis can occur in various organs, including the kidneys. Examples of vasculitis that attack the renal blood vessels and cause glomerulonephritis are polyarteritis and Wegener's granulomatosis.
Immune system disorders
Lupus is an autoimmune disease that can cause inflammation in all organs of the body, including the kidneys and the glomerulus. In addition to lupus, immune system disorders that can also cause inflammation of the glomerulus are:
- Goodpasture's syndrome, which is a condition that resembles pneumonia and can cause bleeding in the lungs and kidneys
- IgA nephropathy, which is a condition that causes the deposition of one of the proteins that are part of the immune system (IgA) in the kidney glomeruli
Chronic glomerulonephritis often has no specific cause. One genetic disease, namely Alport syndrome, can cause chronic glomerulonephritis. Exposure to chemical solvents of hydrocarbons and a history of cancer are also thought to trigger chronic glomerulonephritis.
Symptoms of Glomerulonephritis
Symptoms that appear in patients with glomerulonephritis depend on the type of disease, whether acute or chronic. Symptoms that generally appear include:
- Reddish urine (hematuria)
- Foamy urine
- High blood pressure or hypertension
- Swollen face, hands, feet and belly
- Tired easily
- Decreased frequency of urination
Chronic glomerulonephritis is often difficult to detect because it can develop without causing symptoms. When symptoms appear, the symptoms can resemble those of acute glomerulonephritis. However, in contrast to acute glomerulonephritis, chronic glomerulonephritis makes the frequency of urination increase at night.
When to go to the doctor
Check with your doctor if you experience the complaints or symptoms as mentioned above. Go to the doctor immediately if blood appears in the urine or you are unable to urinate.
If you have a condition or disease that can cause glomerulonephritis, such as lupus, have regular check-ups and follow the treatment prescribed by your doctor.
Diagnosis of Glomerulonephritis
The doctor will ask about the complaints and symptoms experienced and the patient's medical history. Furthermore, an examination will be carried out to see if there is hypertension and swelling in the legs or face.
To establish a diagnosis as well as determine the underlying cause of glomerulonephritis, the doctor will perform a follow-up examination. Several types of examinations will be carried out, including:
- Urine examination, to detect the presence of red blood cells, white blood cells, and protein in the urine
- Blood tests, to determine whether there is a decrease in hemoglobin (anemia) and albumin protein, as well as an increase in the level of waste substances such as urea and creatinine
- Immunological tests, to detect the presence or absence of autoimmune disease with increasing levels of antinuclear antibodies (ANA), complement, antineutrophil cytoplasmic antibodies (ANCA), or antiglomerular basement membrane (anti-GBM)
- Scanning with X-rays, CT scans, or ultrasound, to see kidney conditions in more detail
- Kidney biopsy by taking a sample of kidney tissue, to determine whether the tissue is abnormal and confirm glomerulonephritis
Treatment of Glomerulonephritis
Treatment steps for each patient with glomerulonephritis vary, depending on the type of glomerulonephritis suffered (chronic or acute), the cause, and the severity of the symptoms experienced.
The main goal of treatment for glomerulonephritis is to prevent further kidney damage. Acute glomerulonephritis sometimes goes away on its own without requiring any treatment.
There are several types of glomerulonephritis treatment that can be given, including:
- Immunosuppressant drugs, to treat glomerulonephritis due to autoimmune diseases, for example corticosteroids, cyclophosphamide, ciclosporin, mycophenolate mofetil, and azathioprine
- Antihypertensive drugs, to prevent further kidney damage from increased blood pressure, include: ACE inhibitors (captropil and lisinopril) and ARBs (losartan and valsartan)
- plasmapheresis, i.e. a method for removing harmful plasma with healthy plasma
- Other medications, such as diuretics to reduce swelling and calcium supplements
If glomerulonephritis is caught early, kidney damage can be cured. If glomerulonephritis gets worse and causes kidney failure, the patient must undergo hemodialysis (dialysis) or kidney transplant surgery.
So that kidney damage does not get worse, patients with glomerulonephritis are advised to take several steps, such as maintaining an ideal body weight, stopping smoking, adjusting diet by reducing potassium, protein, and salt intake.
Complications of Glomerulonephritis
Acute glomerulonephritis can sometimes heal without specific treatment. However, if not treated properly, glomerulonephritis can get worse and trigger other diseases. Some of the complications that may occur are:
- Hypertension
- nephrotic syndrome
- Acute kidney failure
- Chronic kidney disease or chronic kidney failure
- Heart failure and pulmonary edema due to fluid buildup in the body
- Electrolyte balance disorders such as sodium and potassium
- Vulnerable to infection