Patient education: Glomerular disease (The Basics)

What is glomerular disease? — This is a condition that affects the kidneys. The kidneys are organs in the urinary tract that make urine (figure 1). Each kidney has 2 parts:

●A part that filters blood and removes waste and excess salt and water

●A part that collects urine

In glomerular disease, the part of the kidney that filters the blood doesn't work normally. As a result, substances that shouldn't be in the urine, such as blood and protein, can get into the urine.

Glomerular disease can happen quickly or slowly over time. There are different types of glomerular disease. Each type has different causes.

Sometimes, glomerular disease causes serious problems. It can cause acute kidney injury, which is when the kidneys suddenly stop working. It can also cause chronic kidney disease, which is when the kidneys slowly stop working.

What are the symptoms of glomerular disease? — The symptoms depend on the type of glomerular disease you have and what's causing it. Some people with glomerular disease have no symptoms. They find out that they have it when their doctor does a urine test for another reason.

When glomerular disease causes symptoms, they can include:

●Bloody urine or urine that is red, pink, or brown

●Foamy urine

●Swelling of the hands, face, feet, or belly

●Feeling tired

●Urinating less than usual

Is there a test for glomerular disease? — Yes. Your doctor or nurse can check for glomerular disease by doing blood and urine tests. These tests can show if your urine has blood or protein in it, and how well your kidneys are working.

Your doctor or nurse will probably do other tests to find out which type of glomerular disease you have. These tests can include:

●Blood tests to check for medical conditions that can cause glomerular disease

●Ultrasound of the kidney – This is an imaging test. It uses sound waves to create a picture of the kidney.

●Kidney biopsy – The doctor puts a thin needle into the back and into the kidney. They remove a tiny sample of tissue from the kidney. Then, another doctor looks at the sample under a microscope.

How is glomerular disease treated? — Treatment depends on your symptoms, what's causing your glomerular disease, and how quickly it happened.

People with mild glomerular disease might not need treatment. But their doctor will do blood and urine tests over time to follow their condition.

Some types of glomerular disease go away on their own. For instance, people can get glomerular disease after they have an infection in another part of their body. This type of glomerular disease usually goes away after the infection is treated.

When glomerular disease does need to be treated, treatments can include:

●Steroid medicines – These help reduce inflammation in the kidneys. They come as pills or as medicines that go into a vein through a thin tube, called an "IV."

●Immunosuppressive medicines – These partly "turn off" the immune system. They include rituximab (brand name: Rituxan), cyclophosphamide (brand name: Procytox), and mycophenolate mofetil (brand name: Cellcept). These medicines can be taken along with steroids.

●Medicines to treat high blood pressure

●Diuretic medicines – These make you urinate a lot.

●Plasmapheresis – A machine pumps blood from the body and filters out substances that are harming he kidney. Then, the machine returns the blood to the body.

People whose kidneys have stopped working might need another treatment called "kidney replacement therapy." This includes 3 different treatments that can do the work of the kidneys. They are:

●Hemodialysis – This is a procedure in which a machine pumps blood out of the body, filters it, and returns it to the body (figure 2). People have hemodialysis at least 3 times a week.

●Peritoneal dialysis – This is a procedure that people do at home every day. It involves piping a special fluid through a tube into the belly. This fluid collects waste and excess salt and water from the blood. Then, the used fluid drains out of the belly (figure 3).

●Kidney transplant – This is surgery in which a doctor puts a healthy kidney in a person whose kidneys are diseased (figure 4).

More on this topic

Patient education: Blood in the urine (hematuria) in adults (The Basics)
Patient education: Swelling (The Basics)
Patient education: High blood pressure in adults (The Basics)
Patient education: Medicines for high blood pressure (The Basics)
Patient education: Acute kidney injury (The Basics)
Patient education: Chronic kidney disease (The Basics)
Patient education: Urinalysis (The Basics)
Patient education: Hemodialysis (The Basics)
Patient education: Peritoneal dialysis (The Basics)
Patient education: Kidney transplant (The Basics)

Patient education: Glomerular disease (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in children (Beyond the Basics)
Patient education: Edema (swelling) (Beyond the Basics)
Patient education: Chronic kidney disease (Beyond the Basics)
Patient education: High blood pressure treatment in adults (Beyond the Basics)
Patient education: High blood pressure treatment in children (Beyond the Basics)
Patient education: Hemodialysis (Beyond the Basics)
Patient education: Peritoneal dialysis (Beyond the Basics)