What Is Glomerular Disease?
One of the most important functions of the kidney is to filter waste from your blood using a million tiny filters called glomeruli. A glomerulus functions similarly to a kitchen colander, allowing waste and water to pass through to form urine. Glomeruli are the tiny network of blood vessels that serve as your kidney's "cleaning units.
The "holes" in the colander are typically not large enough for blood to travel through; instead, blood returns to your body. However, in conditions of glomerular disease, the blood and protein will leak into urine. Glomerular disease treatment vary in severity from mild to severe, with some diseases rapidly progress, leading to loss of kidney function.
Chronic kidney disease commonly occurs from glomerular disease. An estimated 15% of dialysis patients have glomerulonephritis, while another 30% to 50% have other glomerular diseases, such as high blood pressure or diabetic nephropathy.
Causes of Glomerular Diseases
Glomerular disease can be caused by:
- Autoimmune diseases
- Genetic disorders
Sometimes glomerular disease has no identifiable cause. When this happens, it is called idiopathic.
Types Of Glomerular Diseases
The two basic types of the glomerular disease include nephritic and nephrotic, but with some diseases, the two types can overlap.
Nephritic disease ("glomerulonephritis") is defined by the presence of blood (Hematuria) and protein (Proteinuria) in the urine and the presence of hypertension clinically. There may or may not be significant impairment of kidney function. Sometimes, a person suffering from glomerulonephritis may not exhibit any symptoms, and their condition may go unnoticed until blood and protein are discovered during a routine urinalysis.
Hematuria and impaired kidney function are common in people with the more severe nephritic disease. Urine testing may also reveal high protein levels, as well as edema (swelling in the lower legs) or high blood pressure.
Examples of conditions that may cause glomerulonephritis include:Immunoglobulin A (IgA) nephropathy
- Systemic Lupus Erythematosis (SLE)
- Certain bacterial and viral infections (post infectious glomerulonephritis)
- Mixed cryoglobulinemia
- Alport syndrome
- IgA vasculitis (Henoch-Schönlein purpura)
Nephrotic syndrome — People with nephrotic syndrome have protein in the urine (proteinuria) but, often, little to no blood in the urine (hematuria). Kidney function may worsen if nephrotic syndrome progresses with time.
Examples of conditions that may cause nephrotic syndrome include:
- Focal segmental glomerulosclerosis
- Membranous nephropathy (including lupus)
- Diabetic nephropathy
- Post infectious glomerulonephritis (later stage)
- IgA nephropathy
- Primary amyloidosis or the related disorder light chain deposition disease
What are the Symptoms of Glomerular disease?
Glomerular disease symptoms include:
Foamy urine: This indicates that there is a lot of protein in the urine, a condition known as proteinuria.
Urine that is pink or cola-colored: indicates the presence of blood in the urine, a condition known as hematuria.
Hand and ankle swelling: This swelling, known as edema, is common at the end of the day. When you wake up, you may notice swelling around your eyes.
Reduced glomerular filtration rate: This indicates inefficient waste removal from the blood.
Hypoproteinemia: Low blood protein.
Albuminuria: large amounts of protein in the urine
The risk factors for glomerular disease include:
- Kidney diseases and infections
- High blood pressure
- Age above 65
Complications of Glomerular disease:
- High blood pressure
- Acute kidney failure
- Chronic kidney failure
Diagnosis Of Glomerular Disease
Glomerular disease treatment is diagnosed based on the results of blood or urine tests. Other tests, such as imaging tests and a kidney biopsy, may be used to help diagnose the type of glomerular disease.Blood tests — Blood tests are used to measure the levels of creatinine and blood urea nitrogen (BUN), which rise when the kidneys are damaged and not filtering properly. Blood tests can also be used to rule out serious medical conditions (such as diabetes, lupus, or certain infections).
Imaging tests — if the glomerular disease is suspected, a kidney ultrasound is frequently recommended, primarily to rule out other causes of blood in the urine and decreased kidney function. The ultrasound can also measure the size of the kidneys, which can provide a clue as to the duration of kidney disease.
What Are The Glomerular Disease Treatment Options?
Glomerular Disease Treatment depends upon the severity of symptoms, the type of disease, and the cause of the disease. Your specialist may prescribe medications that comprise of:Steroids:
To treat glomerular disease, immunosuppressive medications such as steroids, MMF, and Azathioprine are used. Plasmapheresis is used to remove blood components that cause inflammation if the disease is found to be rapidly progressing.High blood pressure management:
Management of high blood pressure is important to decrease kidney damage. Therefore, anti-hypertensive drugs are prescribed to reduce the amount of proteins in urine and the progression of glomerular disease.Haemodialysis:
Haemodialysis may be required to remove toxins from the blood. This could be suggested as a temporary measure until the kidneys are restored to their original functionality or as a permanent measure if the kidney damage is too severe to treat and undergo irreversible damage.Peritoneal dialysis
Peritoneal dialysis is a type of dialysis procedure that people perform at home. A special fluid is injected into the stomach via a tube. This fluid removes waste as well as excess salt and water from the blood. The used fluid was then drained from the abdomen using a peritoneal dialysis tube.Kidney transplantation:
If your kidneys' functionality is beyond repair, your nephrologist may recommend a kidney transplantation procedure. A healthy kidney from a donor is surgically transplanted into a patient with a chronic disease requiring dialysis.
Can Glomerular Disease Be Prevented?
You can make lifestyle changes to keep yourself healthy and reduce the risk of developing kidney diseases. These changes include:
- Keep a healthy weight.
- Limit your salt intake and avoid adding extra salt to foods.
- Maintain healthy blood pressure. The target pressure is 120/80 mmHg.
- If you have diabetes, you should keep your blood sugar under control. Take all prescribed medications and adhere to all management objectives discussed with your healthcare provider.
- Quit smoking.
- It may not be possible to prevent all the causes of glomerular disease. However, as soon as you notice signs of glomerular disease, consult your doctor.
No matter the cause of your glomerular disease, you have hope at the DR PRANITH RAM Renal Care Centre. DR is the Best Glomerular Disease Doctor to treat conditions across the entire spectrum of kidney disease.
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