Glomerulonephritis

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:

• an infection with a different bacteria or virus
• immunological problems like lupus or Henoch-Schönlein purpura

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.

You also can find more support and information online at:

• The National Kidney Foundation