GLOMERULONEPHRITIS

General Information

DEFINITION--Inflammation of the glomeruli (small, round filters in the kidney). Damaged glomeruli cannot effectively filter waste products from the bloodstream and serious kidney complications may result.

BODY PARTS INVOLVED--Kidneys.

SEX OR AGE MOST AFFECTED--All ages, but most common in children (2 to 12 years).

SIGNS & SYMPTOMS--

Mild glomerulonephritis produces no symptoms. Diagnosis is possible only with urine studies. Severe glomerulonephritis produces the following:

• Smoky or slightly red urine.
• General ill feeling; drowsiness.
• Nausea or vomiting; headaches.
• Fever (sometimes).
• Appetite loss; decreased urination.
• Fluid accumulation in the body, especially puffy eyes and ankles.
• Shortness of breath; high blood pressure.
• Protein in the urine.
• Disturbed vision.

CAUSES

• Acute glomerulonephritis follows a streptococcal infection. The most common infection sites are the throat and skin. Kidney symptoms usually begin 2 or 3 weeks after the strep infection.
• Chronic glomerulonephritis is rare and may have different causes than acute glomerulonephritis.

RISK INCREASES WITH

• Exposure to people in public places where streptococcal infections can be transmitted.
• Streptococcal infection (scarlet fever or erysipelas).

HOW TO PREVENT--Consult your doctor about antibiotic treatment of any infection that may be strep.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory studies, such as: blood counts; repeated urinalyses to determine the presence of protein or other abnormal elements; streptococcal antibody titer (a sophisticated blood study).
• Kidney-function tests.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization (severe cases).

POSSIBLE COMPLICATIONS

• Chronic glomerulonephritis in which the disease tends to progress slowly so that there may be no symptoms until kidneys can no longer function (may be 20-30 years).
• Kidney failure, which may require dialysis or kidney transplant.

PROBABLE OUTCOME--Symptoms subside in 2 weeks to several months. 90% of children recover without complications. Adults recover also--but more slowly.

How To Treat

GENERAL MEASURES--

• Record temperature 3 times a day.
• Collect and record the amount of urine passed in each 24-hour period. Some of this collection will be analyzed in the doctor's office.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Cortisone or cytotoxic drugs, if the illness is severe.
• Diuretics to increase urination.
• Antihypertensives, if high blood pressure accompanies the illness.
• Iron and vitamin supplements, if anemia develops.

ACTIVITY--Stay in bed, except to go to the bathroom, until all signs of illness have passed. Bed rest ensures an adequate blood flow to the kidney; blood flow is best when lying down. Resume normal activities after recovery.

DIET--

• As long as your kidneys function properly, you may eat a normal, well-balanced diet. Greatly decrease the sodium in your diet.
• In severe cases, fluids may need to be restricted, and sodium and protein intake forbidden for a time.

Call Your Doctor If

• You have symptoms of glomerulonephritis.
• The following occur during treatment: Severe headache or convulsion. Failure to pass at least 22 ounces of urine in a 24-hour period. Fever or skin rash. Increased fluid retention. Increased nausea, vomiting or diarrhea.