Glomerular Diseases

Glomerular diseases are specific types of diseases that can cause harm to the various parts of the kidneys which perform the process of filtration of the blood. Some symptoms of glomerular diseases are high blood pressure, blood in urine, foamy urine and swelling in the patients various body parts like ankles, face, hands and feets etc. Glomerular disease can be caused because of various diseases. The most common cause of glomerular disease is diabetes-related nephropathy. Treatment of glomerular diseases may vary on the basis of their causes. 

What is glomerular disease?

Glomerular disease is particularly an outcome of conditions that affects the peculiar part of your kidney which is known as glomeruli. Glomeruli can be defined as a bunch of blood vessels which performs the work of filtration in your kidney. Glomeruli helps in the filtration of extra fluids and wastes from your blood. If the glomeruli of your kidneys get damaged due to any reason and stop performing it’s usual functions then this condition is known as glomerular disease. 

There are various types of conditions and diseases which can be responsible for damaging your glomeruli. Two terms which are usually used to indicate the types of damage on glomeruli includes: 

• Glomerulonephritis, inflammation (swelling) of the glomeruli. 
• Glomerulosclerosis, hardening or swelling of the glomeruli. 

Glomerular disease can be very much harmful for kidneys and in some cases it may also result in kidney failure. 

Work of glomeruli in kidneys? 

Kidney is particularly a two wrist sized and bean shaped organ present in the left and the right of the spine just below the rib cage in the human body. These organs work as a natural filter in the body. 

In the kidneys the blood is supplied by the arteries. After the blood enters your kidneys through the arteries then it moves to the numbers of small looping blood vessels which are known as glomeruli. At the end of each glomerulus a small fluid collecting opening tubes is present which are known as tubules. These glomeruli tubules are also known as nephrons. Around one million nephrons are present in each kidney of an average person.

A completely healthy glomeruli performs the function of making blood cells and protein circulating in the bloodstream of a living being, where it is later consumed by the body. At the same time, it also helps in the filtration of wastes and excess water from the blood by passing them through tubules which further becomes urine. The waste fluid which remains after this process is known as urine and it gets out from the kidney by larger tubes known as ureters, the urine is later transported by these ureters to the bladder. 

How does the kidney interfere with glomerular disease? 

The glomeruli present in kidneys get damaged due to the glomerular disease, which affects their functioning. As an alternative to making blood cells and protein circulating in the bloodstream, glomeruli after getting damaged slip a amount of these substances into your urine. 

This protein loss can be harmful because proteins such as albumin plays the vital role of transporting excess fluids from the body to the bloodstream so that later it can be filtered by the kidney and expelled out from the body in the form of urine. Less amounts of proteins in the body can be responsible for keeping extra fluids in it which may result in swelling in various parts of the body such as feet, abdomen, ankles, face and hands. 

After getting damaged, glomeruli are also unable to perform the work of purification in the body because of which waste products build up will be increased in the body. 

Causes of glomerular disease 

Some of the causes of glomerular disease are: 

• Infection 
• Harmful medication or chemicals. 
• Disease which affects the vital organs, including the kidney. 
• Disease responsible for inflammation or scarring of the nephrons. 
• Any unknown reason. 

Some signs and symptoms of glomerular diseases 

A patient of glomerular disease may have one or more of these symptoms and signs mentioned below: 

• Bloody urine: It means that an amount of blood is present in urine. 
• Swelling on various parts of the body such as feet, abdomen,ankles, face, hands particularly in the morning or at the end of the day. 
• High blood pressure.

How is glomerular disease diagnosed? 

After performing some physical tests and checking medical history of the patients, doctors will suggest the patients to undergo from several tests which will include: 

• Blood test: This test is performed for checking the levels of protein, creatinine and urea nitrogen in the blood. It also helps to check whether your kidneys are working properly or not on the basis of a specific calculation, known as the glomerular filtration rate (GFR). 
• Urine test: This test is performed for checking the amount of proteins, red blood cells and white blood cells in the protein which helps in determining the type and causes of the infection. 

If reports of these tests will indicates towards the damage on the patient’s kidneys, then their doctor may ask them to go through some more tests additionally such as: 

• Extra blood tests for finding out possible causes like autoimmune disease or infection. 
• Ultrasound and CT scan for checking about the shape and the size of the kidney is completely fine or not. 
• Biopsy of kidney, this process concludes the removal of small parts of kidney tissues by the help of needle to view under microscope. 

Causes of glomerular disease and there treatment methods

Glomerular disease can be the result of many diseases. The treatment aims to treat the underlying cause and save your kidneys from more damage. Below we have listed some common causes of glomerular disease examples and treatment for each of them. 

Autoimmune diseases

Autoimmune diseases are the type of diseases in which the immune system of the patient’s body attacks itself. In this disease your whole body or only a few parts and organs of yours gets affected. Few examples of autoimmune disease which affects the kidney and its parts are: 

• Systemic lupus erythematosus (SLE): Systemic lupus erythematosus (SLE) is also known as lupus. In this disease many parts of the body get affected. It is responsible for causing lupus nephritis in the kidney, which is particularly the inflammation of the glomeruli. Further scarring will be caused due to the inflammation of the glomeruli that troubles the kidney in performing its functions properly. This condition of systemic lupus erythematosus (SLE) is treated by the help of Anti- inflammatory treatment which includes immunosuppressive drugs like cyclophosphamide compound with the corticosteroid prednisolone or mycophenolate mofetil. 

• Goodpasture’s syndrome : In this autoimmune disease your kidneys and lungs get affected. Due to this autoimmune disease the kidney gets glomerulonephritis that is the inflammation of the glomeruli and it can result in everlasting damage on the kidney. 

• IgA nephrology: This is the autoimmune disease in which a particular part of the patient’s immune system known as the antibody immunoglobulin (IgA) gets deposited in your glomeruli. These deposited antibody immunoglobulin (IgA) causes inflammation further. Angiotensin- converting enzyme inhibitors or angiotensin receptor blockers are used for the treatment of this autoimmune disease.   

Hereditary nephritis

• Alport syndrome: it is the inherited condition because of which chronic glomerular disease and the vision or hearing impairment is caused. Both males and females get affected by this condition, but chronic kidney disease is experienced by the men, which they know in their twenties and their kidneys completely fail till they get Forty year old . Treatment for this inherited condition includes medications to control blood pressure. 

Glomerular Diseases Associated With Infection 

One the most common cause of development of glomerular disease is infection. 

• Acute post-infectious glomerulonephritis (PIGN): This glomerular disease is caused due to strep throat or skin infection impetigo. In this disease the immune system gets over active and produces a lot of antibodies for fighting the infections which later get settled in glomeruli and later cause damage to them. Generally this condition doesn’t require any specific treatment but in some rare cases it may even require kidney transplantation or dialysis. 

• Bacterial endocarditis: This is the infection of the heart tissues. It is not proven that this disease is responsible for damaging kidneys but still it is suspected. This disease is treated by the help of Antibiotics. 

• Viruses: Infections caused by viruses such as hepatitis B, hepatitis C and human immunodeficiency virus are the most common causes of glomerular disease. Each of these viruses have its own specific treatment.

Sclerotic diseases

• Glomerulosclerosis: It is the scarring of the part present in the kidney which performs the work of filtration which is known as glomerulus, because of this a big amount of protein is lost in the form of urine. This protein helps the excess fluids in satuing in the blood vessels, after their loss the fluid gets lost into the different parts of the body and causes swelling. The two examples of the diseases which cause glomerulosclerosis are diabetes and lupus. 

• Diabetes related nephrology: Diabetes related nephrology is one of the most leading causes of glomerular disease. It is also the cause of the most kidney failure in the United States of America (U.S.A). It scars the kidney and increases the levels of glucose in it. Increased levels of glucose in the blood speeds the flow of blood in the body which creates problems in the function of filtration by the glomeruli and it also raises the blood pressure. Usually this diabetes related nephrology is treated by the help of blood pressure controlling medications such as angiotensin- converting enzyme inhibitors or angiotensin- receptor blockers, healthy diet and regular exercise. 

• Focal segmental glomerulosis (FSGS): In this condition one part of glomerulus gets scarring. Focal segmental glomerulosis (FSGS) disease can be the outcome of body wide disease or any unknown disease. It can be treated by reducing blood pressure and the amount of cholesterol from the blood. 

Other glomerular diseases 

• Membranous nephropathy: This condition is also known as membranous glomerulopathy and it is also the second reason for the most nephropathy cases of United States of America (USA) in adults after diabetes related nephropathy. In this condition the membrane layer of the glomeruli is harmed. Some patients of membranous nephropathy get recovered by themselves only, without any specific treatment. In worst cases of membranous nephropathy the medications such as angiotensin- converting enzyme inhibitors or angiotensin receptor blockers or calcineurin inhibitors are used for treatment. 

• Minimal change disease (MCD): It is the type of nephropathy caused due to the kidney disorder which can further result in nephrotic syndrome. Nephrotic syndrome is particularly a bunch of various types of symptoms such as low protein levels in blood, high amount of protein in blood, high levels of cholesterol and triglyceride in blood. This condition can occur at any age but it is most common in childhood. Treatment of minimal change disease includes, reducing salt intakes, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. 

Can glomerular disease be able to result in kidney failure? 

In case the kidneys are unable to perform its work of filtration and remove the waste out from the body then the waste will start setting down in the body. This settled waste can be harmful for the kidney and even be able to cause trouble in its functions which can later result in the permanent loss of functions. There are two types of loss of functions: acute (sudden) or slow and underlying (chronic). On the basis of the type of glomerular disease, the kidney will stop functioning in days or weeks or may be lost slowly over the years. 

• Acute renal failure (ARF): This is the sudden loss of functions of the kidney. In worst case acute renal failure (ARF) can be also dangerous for life. It may also require necessary care with dialysis for replacing the functions of kidneys. Some people who suffer from acute renal failure (ARF) get their kidney functions back after their cause of kidney failure is treated. It will not consist of any permanent damage. But, some patients develop chronic kidney disease after recovering from acute renal failure. 

• Chronic kidney disease: Chronic kidney disease is the slow and time taking process of losing kidney functions. The symptoms of chronic kidney disease may not be visible for a long time. The diseases which are responsible for causing chronic kidney disease can be slowed down, but chronic kidney disease cannot be fully cured. Afterwards the kidney gets damaged and it cannot be repaired in chronic kidney disease. If chronic kidney disease will remain untreated for a long term then it will evolve into total kidney failure. 

• Total kidney failure: Total kidney failure also known as end-stage renal failure disease (ESRD), it means the complete loss of functions performed by the kidney. After getting total kidney failure AKA as end-stage renal failure disease in order to stay alive, patients will need to take dialysis sessions on a regular basis or need to get a kidney transplantation surgery. 

Tips for preventing glomerular disease 

It will be important for the people who want to avoid the risk of development of disease which can harm their kidneys and for keeping themselves healthy to make changes in their lifestyle. These lifestyle changes includes: 

• Maintaining a healthy weight. 
• Reduction in salt intakes. 
• Controlling the sugar levels in the body.
• Controlling blood pressure.
• Stop smoking.
• Avoid alcohol. 

It is not possible to avoid all conditions which are responsible for causing glomerular disease. Still, the people with symptoms of glomerular disease should take concern from the doctor as soon as possible. It is also very much necessary to find the treatable causes of disease and start its treatments as early as possible. Treatment helps to slow down the progression of kidney disease or prevent it from becoming worse.

What should I do if I have glomerular disease? 

For getting a good outcome one of the most appropriate ways is to get early diagnosis and early treatment. The treatment goals are to reduce or decrease the progression of damage to the kidney. Kidney failure can be caused if damage gets in its worst condition, after the kidney failure there will be only two options remaining: kidney transplantation surgery or dialysis.

What is nephrosis? 

Nephrosis is also commonly known as nephrotic syndrome. It is a bunch of symptoms. When a nice amount of protein of the bloodstream is removed by your body in the form of urine, it results to excess fluid build up in your body. Symptoms of nephrotic syndrome also known as nephrosis includes: 

• High cholesterol levels 
• High blood pressure 
• Low levels of protein in blood 
• High levels of protein in urine. 
• Swelling, especially in feets, ankles, hands , face and around the eyes.  

The treatment goals to treat the known underlying cause. Few treatments of nephrosis includes: 

• Taking medications to lower the levels of cholesterol in the body. 
• Taking immunosuppressant drugs like corticosteroids. 
• Reducing the salt intakes.
• Taking diuretics for preventing the fluid build up in the body. 
• Taking medications like angiotensin- converting enzymes inhibitors or angiotensin receptor blockers for controlling blood pressure and preventing the protein loss from the body in the form of urine. 
• Using plasmapheresis for the removal of antibodies that are causing damages to their own body. 

The nephrosis cannot be cured if a kidney disease is the underlying cause of it. If glomeruli which are present in kidneys get unable to function properly then this will result in waste and fluid build up in the blood.