Glomerulonephritis (GN) is a serious kidney condition that affects the glomeruli, tiny blood vessels responsible for filtering waste and excess fluid from the bloodstream. Dr Aniket Hase, consultant nephrologist at Jupiter Hospital, Thane, explains that GN can lead to complications like high blood pressure, kidney failure, or even kidney disease. end stage renal disease (ESKD). Worryingly, GN contributes to 25-30 percent of all ESKD cases requiring dialysis or kidney transplantation, making it a major health issue.

What is glomerulonephritis?

“Glomerulonephritis can be classified into primary and secondary forms,” says Dr. Hase.

-Primary GN originates in the glomeruli of the kidney.

– Secondary GN arises from systemic diseases or external factors such as infections, autoimmune disorders or metabolic conditions such as diabetes.

“GN can develop suddenly over a few days or weeks, known as acute GN, or progress slowly over months or years, known as chronic GN. Without timely intervention, both forms can lead to ESKD,” says Dr. Hase.

A study published in Kidney International highlights that patients with chronic GN have a 50 percent higher risk of developing ESKD if they do not receive treatment. This underlines the importance of early diagnosis and intervention.

Symptoms of glomerulonephritis: what to look for

According to Dr. Hase, the symptoms of GN often depend on its underlying cause. However, some common signs include:

“One of the well-known symptoms is hematuria,” says Dr. Hase. Blood may cause urine to appear pink or brown, or it may only be detected under a microscope.

Damage to the glomeruli often causes protein to leak into the urine, making it foamy or bubbly.

“Swelling in the face, legs, or abdomen is a clear sign of fluid retention due to poor kidney function,” explains Dr. Hase.

– high blood pressure:

GN causes salt and water retention, which can lead to high blood pressure. A study in Hypertension Research found that 70 percent of patients with GN have elevated blood pressure, which can lead to further kidney damage.

“As kidney function declines, toxins build up in the blood, causing extreme fatigue,” says Dr. Hase.

He added, “These symptoms can develop subtly or suddenly, so regular medical checkups are important, especially for people at high risk.”

Causes of glomerulonephritis

Dr. Hasse explains that GN can be caused by a variety of causes, including infections, autoimmune conditions, and hereditary factors:

“Post-streptococcal glomerulonephritis is a common form that occurs after a throat or skin infection caused by Streptococcus bacteria,” says Dr. Hase. He adds that other infections, such as hepatitis B, hepatitis C, or HIV, can also trigger GN.

Conditions such as lupus and Goodpasture syndrome cause the immune system to attack the glomeruli. “This autoimmune response leads to inflammation and damage,” explains Dr. Hase.

– IgA Nephropathy:

“This is one of the most prevalent causes of chronic GN,” says Dr. Hase. Abnormal IgA proteins accumulate in the kidneys, causing inflammation.

Dr. Hase says conditions like Alport syndrome or inflammation of the blood vessels can also cause GN and kidney failure.

A study in The New England Journal of Medicine emphasizes the importance of early diagnosis, noting that patients with IgA nephropathy face a 30 percent risk of kidney failure within 20 years.

As to why 25-30 percent of ESKD cases are from GN, Dr. Haase explains, “GN often turns into ESKD due to delayed diagnosis or inadequate treatment.” Major factors include:

– Late detection:

“Some forms, such as IgA nephropathy, progress slowly and may not be diagnosed until the advanced stages,” says Dr. Hase.

-Uncontrolled blood pressure and proteinuria:

High blood pressure and excessive protein loss in the urine increase kidney damage.

– Comorbidities:

“Conditions such as diabetes, smoking, and heart disease significantly increase kidney damage,” says Dr. Hase.

The Journal of the American Society of Nephrology estimates that 40 percent of ESKD cases can be prevented by timely management of GN.

How to Prevent Glomerulonephritis

“A comprehensive approach is needed to prevent GN from progressing to ESKD,” says Dr. Hase. Here are their key strategies:

1. Regular monitoring

“Regular urine and blood tests are important,” Dr. Hasse emphasizes. Early detection of proteinuria or hematuria can allow timely intervention.

2. Treating the underlying cause

“It’s important to rule out infections or autoimmune disorders,” he says. For example, post-streptococcal GN often resolves with antibiotics, while autoimmune GN requires immunosuppressants.

3. Blood pressure control

Dr. Hasse emphasizes that “keeping blood pressure within the target range is one of the most effective ways to slow the progression of the disease.”

One study on hypertension found that controlling blood pressure reduced the progression of GN by 30 percent in patients treated with ACE inhibitors or ARBs.

4. Diet and lifestyle modifications

“Patients should follow a kidney-friendly diet low in sodium, protein, and potassium,” explains Dr. Hase. He also recommends avoiding smoking and limiting alcohol consumption.

5. Advanced Intervention

“For ESKD patients, dialysis or kidney transplantation is lifesaving,” says Dr. Hase. With advances in transplant techniques, survival rates have improved significantly.

Dr. Hase explains that GN is not a death sentence. “With the right treatment, many patients can live healthy, full lives,” he says.

A case study published in the Clinical Kidney Journal shared the story of a patient with IgA nephropathy who stabilized kidney function through early intervention, blood pressure control, and lifestyle changes.

“This shows that even in chronic GN, proactive care can make a difference,” says Dr. Hase.

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