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Primary Glomerulonephritis


Overview, Causes, & Risk Factors

Primary glomerulonephritis, or GN, involves damage to the glomeruli in the kidneys. Glomeruli are the filtering structures of the kidneys. When glomeruli are damaged, protein and blood cells may leak into the urine.

What is going on in the body?

Primary GN stems from damage to the glomeruli. Most often this is the result of inflammation of the tissue. The injury can be mild with few symptoms. It can also be severe and life threatening.

Six major syndromes are associated with primary GN, including:

  • acute glomerulonephritis, which may develop suddenly after a throat, skin, or upper respiratory infection
  • blood in the urine, called hematuria
  • chronic glomerulonephritis, which develops slowly
  • nephrotic syndrome, which causes a set of symptoms including bodywide swelling
  • protein in the urine, called proteinuria
  • rapidly progressive glomerulonephritis, which often follows a kidney inflammation and causes rapid loss of kidney function
  • What are the causes and risks of the disease?

    Several factors can contribute to the risk for primary GN. These include the following:

  • autoimmune disorders, such as a condition called systemic lupus erythematosus
  • certain cancers
  • chronic hepatitis, an infection of the liver
  • genetic tendencies
  • infections, such as a heart infection known as endocarditis
  • rheumatic fever, an immune response that may follow a group A streptococcal infection such as strep throat

  • Symptoms & Signs

    What are the signs and symptoms of the disease?

    Following are some of the symptoms of GN:

  • blood in the urine
  • decreased or increased urine output
  • high blood pressure
  • shortness of breath
  • swelling, especially in the hands, feet, ankles, and face
  • Primary GN can also cause uremia. This is a high level of waste products in the blood. Symptoms of uremia include:

  • cognitive impairments, or changes in mental status
  • fatigue
  • hiccups
  • nausea and vomiting

  • Diagnosis & Tests

    How is the disease diagnosed?

    Diagnosis of GN begins with a medical history and physical exam. The healthcare provider may also order blood and urine tests. Blood tests useful in making the diagnosis include:

  • antibody titer tests that may detect an autoimmune disorder
  • antibody titer tests that may detect an infection such as chronic hepatitis
  • protein tests that may detect a cancer
  • protein tests that may detect inflammation of the kidney
  • A renal biopsy may be needed to confirm the diagnosis. The biopsy involves using a special needle to obtain a piece of tissue from the kidney. The tissue is then examined under a microscope.


    Prevention & Expectations

    What can be done to prevent the disease?

    Treatment of the underlying disease or infection may prevent some cases of GN. Practicing good hygiene and safer sex may also prevent this condition. Individuals should also avoid illegal drug use.

    What are the long-term effects of the condition?

    An infection that is treated promptly may cure the cause of the GN, and there may be no long-term effects. The longer the condition goes untreated, the more devastating it can be. The kidneys and renal system can be permanently damaged. Other long-term effects depend on the underlying cause.

    What are the risks to others?

    Glomerulonephritis is not contagious and poses no risk to others. If an infection, such as hepatitis, causes it, the infection may be contagious.


    Treatment & Monitoring

    What are the treatments for the disease?

    Treatments for primary GN are as follows:

  • ACE inhibitors, such as enalapril, lisinopril, or captopril
  • antibiotics for infection
  • bed rest to increase the blood flow to the kidneys and give the kidneys a chance to heal
  • chemotherapy for cancer related causes
  • corticosteroids, such as prednisone or dexamethasone
  • cytotoxic agents, which kill cancer cells
  • diuretics or water pills
  • hemodialysis, or hooking the person up to a machine that filters the blood
  • immunosuppressive medicines, which decrease the body's attack on the glomeruli
  • kidney transplant
  • a special diet for kidney disease
  • What are the side effects of the treatments?

    Long-term use of corticosteroids can cause osteoporosis. Immunosuppressive and cytotoxic therapies can increase a person's risk of infections and cancer.

    What happens after treatment for the disease?

    Expectations for recovery vary according to the type and extent of the disease. If the cause is reversible and is treated, no further treatment may be required. A person can often return to normal activities. Treatment may be prolonged if the underlying cause cannot be fixed. Some individuals may develop chronic glomerulonephritis or kidney failure.

    How is the disease monitored?

    Someone who has primary GN will have regular visits with the healthcare provider. Blood pressure and kidney function will be monitored. Any new or worsening symptoms should be reported to the healthcare provider.


    Attribution

    Author:Crystal R. Martin, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:08/31/01
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/27/01


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