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Glomerulonephritis
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Glomerulonephritis

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Acute glomerulonephritis refers to a specific set of renal diseases in which an immunologic mechanism triggers inflammation and proliferation of glomerular tissue. Hippocrates originally described the manifestation of back pain and hematuria, which lead to oliguria or anuria. With the development of the microscope, Langhans was able to describe the corresponding glomerular changes. Most original research focuses on the poststreptococcal patient.

Treatment 

Treatment and outcome of glomerulonephritis depend on whether you have an acute or chronic form of the disease, on the underlying cause, and on the type and severity of your symptoms. Some cases of acute glomerulonephritis, especially those that follow a strep infection, often improve on their own and require no treatment.

To control your high blood pressure and slow the decline in kidney function, your doctor may prescribe one of several medications:

  • Diuretics. Diuretics, including furosemide (Lasix) and those containing hydrochlorothiazide (Accuretic, Lotensin HCT), reduce the amount of fluid in your body. They cause your kidneys to excrete more sodium in your urine than they would normally. The sodium takes with it water from your blood. This means there's a smaller volume of blood pushing through your arteries and, consequently, less pressure on your artery walls. In addition, diuretics can help reduce the fluid retention (edema) or fluid buildup in your body.

  • Angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors, such as benazepril (Lotensin) and fosinopril (Monopril), help relax your blood vessels, which lowers blood pressure. ACE inhibitors block the formation of angiotensin II, a natural chemical inside your body that narrows the diameter of arteries.

Your doctor also may prescribe drugs to treat the underlying cause of glomerulonephritis. If you have an active strep or other bacterial infection, your doctor likely will prescribe an appropriate antibiotic. Doctors often prescribe corticosteroids and immune-suppressing drugs for people who have lupus or vasculitis. Fish oil supplements have been successful in some people with IgA nephropathy.

Therapies for associated kidney failure
For acute glomerulonephritis and acute kidney failure, temporary dialysis can help remove excess fluid and control high blood pressure. The only therapies for end-stage kidney failure are kidney dialysis and kidney transplantation. When a transplant isn't possible, often because of poor general health, dialysis becomes the only option.

Prevention 

There's no way to prevent most forms of glomerulonephritis. However, you can seek prompt treatment of a strep infection causing a sore throat or impetigo. Also, practicing good hygiene and safer sex and avoiding intravenous drug use can help prevent infections such as HIV and hepatitis that can lead to some forms of glomerulonephritis. Controlling your blood sugar may prevent diabetic glomerulosclerosis, and controlling your blood pressure makes hypertension-related nephrosclerosis less likely.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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Last Modified : 03/15/08 12:53 AM