Glomerulonephritis

What Are the Symptoms of Glomerulonephritis?

The following are the most common symptoms of glomerulonephritis. However, each child may experience symptoms differently. Symptoms may include:

• Dark brown-colored urine (from blood and protein)
• Sore throat
• Diminished urine output
• Fatigue
• Lethargy
• Increased breathing effort
• Headache
• High blood pressure
• Seizures (may occur as a result of high blood pressure)
• Rash, especially over the buttocks and legs
• Weight loss
• Joint pain
• Pale skin color
• Fluid accumulation in the tissues (edema)
• Fever

The symptoms of glomerulonephritis may resemble other conditions and medical problems. Always consult your child's doctor for a diagnosis.

What Causes Glomerulonephritis?

Glomerulonephritis is caused by several different disease states, including the following:

• Systemic immune disease, such as systemic lupus erythematosus (SLE or lupus)

Other systemic diseases may include:

• Henoch-Schönlein purpura. A disease usually seen in children that is associated with purpura (small or large purple lesions on the skin and internally on the organs) and involves multiple organ systems.

A form of inherited glomerulonephritis called Alport syndrome, which affects both men and women; men are more likely to have kidney problems. Treatment focuses on preventing and treating high blood pressure and preventing kidney damage.

• IgA Nephropathy in which abnormal IgA antibodies are deposited within the glomeruli.

In children, a common cause of glomerulonephritis is from a streptococcal infection, such as strep throat or upper respiratory infection. Glomerulonephritis usually occurs more than one week after an infection. This is often referred to as acute poststreptococcal glomerulonephritis or PSGN.

How Is Glomerulonephritis Diagnosed?

In addition to a thorough physical examination and complete medical history, your child's doctor may recommend the following diagnostic tests:

• Throat culture
• Urine tests
• Blood tests
• Electrocardiogram (ECG or EKG). A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle damage.
• Renal ultrasound (also called sonography). A noninvasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities.
• Chest X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• Renal biopsy. A procedure during which a small sample of tissue is taken from the kidney through a needle. The tissue is sent for special testing to determine the specific disease.

What Is the Treatment for Glomerulonephritis?

Specific treatment for glomerulonephritis will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history
• The extent of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

Treatment for glomerulonephritis may include:

• Fluid restriction
• Decreased salt and potassium diet

Medication, such as:

• Diuretics
• Blood pressure medications
• Phosphate binders. Medications to decrease the amount of the mineral phosphorus in the blood.
• Immunosuppressive agents (e.g. steroids)
• Dialysis. A medical treatment to remove wastes and additional fluid from the blood after the kidneys have stopped functioning. Dialysis may be required for short-term or long-term therapy.

If glomerulonephritis does not resolve, long-term kidney failure may need to be addressed.