What Is Glomerulonephritis?
Glomerulonephritis (gluh-MARE-you-low-ne-FRY-tis) is a kidney
problem.
The kidneys are fist-sized organs shaped like kidney beans. They clean blood and
help remove waste that goes into pee (urine).
When a child has glomerulonephritis (GN), the kidneys don't work properly and can't
clean the blood well. This can happen quickly (acute GN) or slowly
over time (chronic GN).
GN causes problems with urinating (peeing) and swelling in parts of the body, like
the face and hands. In some cases, it can lead to kidney damage or kidney failure.
Medicine and changes in diet and other health habits can help slow down or reverse
damage to the kidneys.
What Happens in Glomerulonephritis?
Inside the kidneys are balls of tiny blood vessels called glomeruli. They are the
part of the kidneys that clean the blood and remove waste and extra fluids, which
leave the body in pee.
In glomerulonephritis, the glomeruli are swollen and irritated (inflamed). They
stop working well, and blood cells and protein can leak into the pee. When this happens,
fluids can also leak out of the blood vessels into the body's tissues. This causes
swelling in the face, belly, hands, and feet.
What Are the Signs & Symptoms of Glomerulonephritis?
Glomerulonephritis can cause:
- puffiness in the face (more noticeable in the morning)
- the kidneys to make less pee than usual
- red or brown pee (hematuria)
- foamy or bubbly pee (proteinuria)
- high blood pressure
(hypertension)
With chronic GN, symptoms can develop slowly over many months or years. Some kids
won't have noticeable symptoms at first. Doctors may find the condition if a routine
urine test detects blood
and/or protein, or after
a child is diagnosed with high blood pressure.
In some cases, chronic GN can lead to more kidney damage, and even kidney failure
(when the kidneys no longer can clean the blood well). Symptoms of kidney failure
include:
- peeing too much or too little
- loss of appetite
- nausea and vomiting
- weight loss
- muscle cramps at night
- tiredness
- pale skin
- high blood pressure
- headaches
- swelling or puffiness
If your child has any of these problems, it's important to see a doctor right away
to find the cause. Having one of these signs alone doesn't mean a child has kidney
failure. But when a few of these things happen together, that's a clue that kidney
failure is possible.
What Causes Glomerulonephritis?
Acute GN sometimes happens after streptococcal bacteria
cause a throat or skin infection. Other causes include:
Chronic GN can be passed down in families, but sometimes doctors don't know what
causes it.
How Is Glomerulonephritis Diagnosed?
Doctors diagnose glomerulonephritis by doing an exam and asking about symptoms.
The doctor may order blood tests and get a urine sample for testing. The doctor also
might order a kidney ultrasound to get a better look at the kidneys. Ultrasounds use
sound waves to create images of organs and other body parts.
In some cases, a child may have a kidney biopsy.
During a kidney biopsy, a tiny bit of kidney tissue is removed and sent to a lab for
testing.
How Is Glomerulonephritis Treated?
Acute Glomerulonephritis
Sometimes acute glomerulonephritis gets better on its own. Treatment, if needed,
depends on the cause and a child's age and overall health.
When an immune system problem
causes GN, kids will get steroids and other drugs that help suppress the immune system.
Antibiotics can treat a bacterial infection. Some kids may need a treatment to clean
the blood using an artificial filter, called dialysis, if their kidneys
are greatly and irreversibly damaged.
To deal with uncomfortable symptoms, doctors may give medicines to lower blood
pressure or help the kidneys make pee and get rid of waste. A child might need to
drink less fluids than usual and eat a diet that's low in protein, salt, and potassium.
In most cases of acute GN, the damage to the glomeruli eventually heals. How long
this takes is different for every child. Acute GN that doesn't respond to treatment
can become chronic.
Chronic Glomerulonephritis
To help healing and prevent more damage to the kidneys, kids should:
- eat a healthy diet with less protein, potassium, phosphorus, and salt
- get plenty of exercise (at least 1 hour a day for kids age 2 and older)
- drink less fluids
- take calcium supplements
- take medicines to lower high blood pressure
When these methods don't help enough to prevent lasting kidney damage, kids may
need dialysis treatments or a kidney
transplant.
How Can Parents Help?
Follow the doctor's advice to help protect your child's kidneys and give your child
the best chance of slowing down or stopping kidney damage or failure.
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