Chronic glomerulonephritis causes destruction of the glomeruli in the kidneys. Each glomerulus is made up of blood vessels that filter blood and help produce urine, so as they become dysfunctional, the kidneys begin to have difficulty filtering blood. This can cause early symptoms, such as small amounts of blood in the urine. Some cases resolve without treatment, but for many, treatment is necessary to sustain life.
Many times, the causes of chronic glomerulonephritis are not easily identified. Certain diseases can predispose a patient to developing this condition, including autoimmune disorders such as end-stage AIDS, lupus, and some blood sugar disorders such as diabetes. However, in about 25% of people, the cause is unknown and those affected have had no prior problems with kidney health.
The condition is often diagnosed by urinalysis, which will show blood and protein in the urine. Since it often causes high blood pressure, people with hypertension are also often screened for the disease. Additional tests that can confirm the condition are ultrasounds of the abdomen and kidneys, and chest x-rays. Patients often retain fluid, which can be shown in the lungs. Some medical professionals also prefer to biopsy the kidneys, since identifying the cause when possible can alter treatment.
Treatment for chronic glomerulonephritis may depend on the cause, if it can be identified. One of the main concerns is controlling high blood pressure, which although it is a cause of the disease, it can also contribute to making it worse. Also, high blood pressure alone poses an increased risk of stroke and should be treated. Hypertension is typically treated with a variety of blood pressure medications, and patients may also require a salt- and fluid-restricted diet.
In severe cases, kidney dialysis or a kidney transplant is required to help the body properly filter blood products. Transplantation can often stop the disease, but it can be difficult to obtain. If the disease is caused by conditions such as AIDS, lupus, or diabetes, a transplant may not be successful. The condition can also recur in the transplanted kidney.
The success of treatment depends on the degree to which the symptoms can be controlled or stopped. Severe damage to the kidneys, called nephrotic syndrome, can be irreversible. When such damage can be controlled, patients can recover well. Of course, the outcome of treatment also depends on the cause, and with diseases like AIDS, the condition tends to get progressively worse.