The kidneys normalize or control blood pressure, intensify production of RBC or red blood cells, and accountable for the filtration of blood to eliminate that’s not needed, supporting and keeping the body’s chemistry in balance (BBC 2006). Each kidney has an estimated 1 million tiny filtering units known as nephrons, and each of these is composed of a knot of capillaries or glomerulus that filter or clean the blood, and along thin tube known as renal tube in which important substances like glucose are reabsorbed in the blood to be utilized again (BBC 2006).
The total amount of blood in the body passes through the kidneys at around 300 times per day ensuring any waste products and extra water are eliminated from the body. Despite increasing knowledge of the underlying disease mechanisms, advance treatment in have been slow. However in recent years it has become apparent that the prognosis in various forms of glomerulonephritis can be improved by appropriate immunosuppressive therapy (Pusey 1999).
Glomerulonephritis or glomerular nephritis (GN) is a type of disease in the kidney or a “primary or secondary immune mediated renal disease” that hinder that kidney’s capability to excrete and filter excess fluids and waste, characterized by swelling of the glomeruli or the kidney’s small blood vessels and may introduce with secluded proteinuria or hematuria or as nephritic syndrome or acute or renal failure or malfunction. According to studies, glomerulonephritis may be due to certain or particular problems with the immune system of the body, but the specific or exact cause of some cases are unknown as of this time (University 2007).
Glomerulonephritis is categorized into many different pathological arrangements classified as proliferative or non proliferative glomerulonephritis, and it can also be acute which means that it pertains to sudden attack or can be chronic pertaining to the disease coming on gradually (Mayo 2007). Glomerular disease can be a disease by itself or it can be a section of a systematic disease like in diabetes or lupus, and the therapy is according to the type of glomerulonephritis a person have.
Great post to read – What are Kidney Infections?
The immune mechanism involve in glomerulonephritis can be considered at a number of different levels. First the mechanism which involve specific recognition, that is the binding of particular antigens or fragments of antigens by the recognition molecules of B cells (antibodies) or T cells (the T receptor). Second, there are varieties of non-specific mediator systems, often recruited by this specific element, which are involved in the mediation of tissue damage. These include both cellular (e. g.
neutrophils, monocytes) and non cellular (e. g. complement) systems. Finally, a variety of mechanisms such as chemo attractive cytokines and adhesion molecules on the endothelium are involved in recruiting cellular members of both the specific and on specific systems into the site of inflammations in the glomerulus (Pusey 1999). Signs and Symptoms Glomerulonephritis’ signs and symptoms depends on whether it is chronic or acute, the first clue or sign that something is wrong may come from the results of a urinalysis.
Some of the signs and symptoms that can be seen with a person having glomerulonephritis includes: Diluted ice tea or cola colored urine from the RBC (red blood cells) or what is called hematuria, foam in the toilet water from protein in the urine or what is called proteinuria, high blood pressure or hypertension, fluid retention or edema with the swelling evident in the face, hands, feet and abdomen, fatigue from anemia or kidney failure, and less frequent urination than usual (Mayo 2007).
Other symptoms are: unintentional weight loss, nausea, vomiting, fatigue, headache, frequent hiccups, generalized itching, need to urinate at night, easy bruising or bleeding, decreased alertness, muscle twitching, muscle cramps, seizures, increased skin pigmentation, decreased sensation, nosebleed, high blood pressure, and blood in the vomit or stools (University 2007). Causes Glomerulonephritis is a disease that can result to kidney failure and this is due to immune diseases, infections, inflammation of the blood vessels or vasculitis and conditions that damage or make scar at the glomeruli, but the exact cause is unknown (Mayo 2007).
Some of the causes of glomerulonephritis are: infections such as post streptococcal glomerulonephritis which may develop after strep infection in the throat or on the skin such as impetigo, bacterial endocarditis or the spreading of bacteria through the bloodstream which may go to the heart causing infection of the heart’s valvular tissue, and viral infections such as HIV, Hepatitis B & C which may trigger glomerulonephritis affecting the liver, immune diseases such as Lupus or the chronic inflammatory disease affecting most of the body parts such as kidneys, blood cells, joints, lungs, and heart, Goodpasture’s syndrome or a unusual immune lung disorder that may copy pneumonia resulting deposition of immunoglobulin A (IgA) in the glomeruli which may progress from years unnoticeable, vasculitis such as Polyateritis or a form of vasculitis affecting small and medium blood vessels in most body parts like kidneys, heart, and intestines, and Wegener’s granulomatosis or a vasulitis’ form affecting the upper airways, kidneys, and the lungs, and conditions scarring the glomeruli such as high blood pressure destroying the kidneys and its capability to have its normal functions, Diabetic kidney disease, and Focal Segmental glomerulosclerosis characterized by scarring of the glomeruli resulting from another disease (Mayo 2007). Screening and Diagnosis The urinalysis may show RBC which indicating the possibility of glomeruli damage; white blood cells indicating possible infection; and increased protein count indicating nephron damage, and other indicators such as increased blood levels of urea or creatinine, and hard to control blood pressure (Mayo 2007).
Some of the diagnosis or tests which can be given by doctors are: urinalysis, abdominal ultrasound, abdominal CT scan, chest x-ray, kidney biopsy, urine specific gravity, urine concentration test, uric acid test, urine RBC, urine protein, creatinine clearance, complement component 3, complement, BUN, anti-glomerular basement membranes, and albumin test (University 2007). Complications The possible complications of glomerulonephritis includes, acute kidney failure which may result in the loss of nephron’s filtration functioning causing waste products to build up rapidly, in which a dialysis will be needed, Chronic kidney failure causing extreme complications losing kidney’s function to only 10% its normal functioning, requiring kidney transplant or dialysis, High blood pressure which may result due to accumulation of waste in the bloodstream, and Nephrotic syndrome which affects the filtering ability of kidney’s glomeruli (Mayo 2007). Treatment
In controlling high blood pressure and declining kidney function, medications can be taken, such as diuretics, ACE inhibitors, Angiotensin II receptor agonists, calcium channel blockers, and beta blockers, (Mayo 2007) corticosteroids, immunosuppressives, dietary restrictions on fluid, salt, protein and other substances, and/or dialysis or kidney transplantation in controlling renal failure (University 2007). Prevention There is no exact prevention for most glomerulonephritis but in some situations it can be prevented through the avoidance of contact to mercury, solvents, and non-steroidal anti inflammatory analgesics (University 2007), treatment of streptococcal infections, following safe sex guidelines to avoid infections like AIDS, and avoiding intravenous drugs (Mayo 2007).