Glomerulonephritis

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.

Your kidneys are complex organs whose primary task is to remove waste and excess fluid from your body. Any condition that interferes with kidney function can lead to a potentially dangerous buildup of waste products in your bloodstream.

Glomerulonephritis is a type of kidney disease caused by inflammation or scarring of the small blood vessels (glomeruli) that are part of the kidneys' filtering mechanism. The inflammation damages the membranes of the glomeruli, hampering your kidneys' ability to remove waste and excess fluids.

Glomerulonephritis, also called glomerular disease, can be either acute, involving a sudden attack of inflammation, or chronic, which comes on gradually. It may be reversible, sometimes improving without treatment. Chronic glomerulonephritis, however, which is characterized by persistent inflammation of the glomeruli, commonly leads to gradual kidney failure.

Glomerular disease can be part of a systemic disease, such as lupus or diabetes mellitus, or it can be a disease by itself, primary glomerulonephritis. Treatment depends on the type of glomerulonephritis you have. In the chronic form, management of symptoms often can delay kidney failure.

Signs and symptoms 

Signs and symptoms of glomerulonephritis may depend on whether you have the acute or chronic form, and the cause. Your first indication may come from symptoms or from the results of a routine urinalysis.

Signs and symptoms may include:

• Cola- or tea-colored urine from blood in your urine (hematuria)

• Foamy urine from protein in your urine (proteinuria)

• High blood pressure (hypertension)

• Fluid retention (edema), with swelling possibly evident in your face, hands, feet and abdomen

• Fatigue from anemia or kidney failure

• Less frequent urination than usual

• Endocarditis

• fatigue

• high blood pressure

• Kidney failure

Causes 

Your kidneys are two bean-shaped, fist-sized organs situated near the middle of your back, just below your rib cage, with one on each side of your spine. Blood enters your kidneys through arteries from your aorta. Each kidney contains approximately 1 million tiny filters (glomeruli), each of which is attached to the opening of a small fluid-collecting tube (tubule). The glomerulus and tubule form a nephron, the functional unit of the kidneys.

The glomeruli filter the blood as it passes through your kidneys. Then the filtered blood travels through veins in the kidneys back to your bloodstream. The waste, after being modified by the tubules, goes to your bladder as urine through a tube from each kidney (ureter) and passes out of your body when you urinate.

Every day, about 2 quarts of waste products and extra water leave your body as urine. When your kidneys lose their filtering ability, dangerous levels of fluid and waste accumulate in your body, a condition known as kidney failure.

The causes of glomerulonephritis are many. They include those related to infections, immune diseases, inflammation of the blood vessels (vasculitis) and conditions that scar the glomeruli. Here's a sampling:

Infections

• Post-streptococcal glomerulonephritis. Glomerulonephritis may develop after a strep infection in your throat or, rarely, on your skin (impetigo). Post-infectious glomerulonephritis is uncommon, however, especially because of rapid antibiotic treatment of most streptococcal infections.

• Bacterial endocarditis. Bacteria from another part of your body, such as your mouth, can spread through your bloodstream and lodge in your heart, causing this infection of the valvular tissues inside the heart. Those at greatest risk are people with a heart defect, such as a damaged or artificial heart valve.

• Viral infections. Among the viral infections that may trigger glomerulonephritis are the human immunodeficiency virus (HIV), which causes AIDS, and the hepatitis B and hepatitis C viruses, which affect the liver and can become chronic infections.