Glomerulonephritis
Overview
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 peeing (urinating) 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 GN, which used to be called Bright's disease, 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.
Top Things to Know
- Glomerulonephritis (GN) is a condition that makes it harder for the kidneys to get rid of extra fluid and waste.
- Kids with GN may have a puffy face, high blood pressure, and changes in pee.
- Symptoms happen quickly with acute GN and slowly with chronic GN.
- Treatment can include medicine, diet changes, and dialysis.
Signs & Symptoms
What Are the Signs & Symptoms of Glomerulonephritis?
GN 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.
Kidney Failure
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.
Causes
What Causes Glomerulonephritis?
Acute GN sometimes happens after streptococcal bacteria cause a throat or skin infection (post-streptococcal glomerulonephritis). Other causes include:
- infection with different bacteria or a 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.
Diagnosis
How Is Glomerulonephritis Diagnosed?
Doctors diagnose GN 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.
Treatment & Care
How Is Glomerulonephritis Treated?
Acute Glomerulonephritis
Sometimes acute GN gets better on its own. Treatment, if needed, depends on the cause and the child's age and overall health.
When an immune system problem causes GN, kids will get steroids and other medicines 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 one hour a day for kids age 2 and older).
- Drink less fluid.
- 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.
