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What is glomerulonephritis

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					What is glomerulonephritis / Nephritis / Nephrotic Syndrome?

Each kidney contains about 1-3 million nephrons and they
are the functional unit of the kidney.Each nephron contains a
structure called the glomerulus through which the
bloodvessels pass and the waste products of the body get
.purified

Glomerulonephritis is the term used to describe a group of
diseases that damage the part of the kidney that filters blood.
When the kidney is damaged, it cannot get rid of wastes and
extra fluid in the body. If the illness continues, the kidneys
.may stop working completely

How do glomerular diseases interfere with kidney function?
Glomerular diseases damage the glomeruli, letting protein
and sometimes red blood cells leak into the urine. Sometimes
a glomerular disease also interferes with the clearance of
waste products by the kidney, so they begin to build up in the
blood. Furthermore, loss of blood proteins like albumin in the
urine can result in a fall in their level in the bloodstream. In
normal blood, albumin acts like a sponge, drawing extra fluid
from the body into the bloodstream, where it remains until
the kidneys remove it. But when albumin leaks into the urine,
the blood loses its capacity to absorb extra fluid from the
body. Fluid can accumulate outside the circulatory system in
the face, hands, feet, or ankles and cause swelling.

What are the different types of glomerulonephritis?
There are many types of Glomerulonephritis,but for
convenience it is divided into two types

a. acute
b. chronic.




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What are the diagnostic Tests that might be done?
 Acute:The acute form develops suddenly. You may get it
after an infection in your throat or on your skin. Sometimes,
you may get well on your own.Other times, your kidneys may
stop working unless effective treatment is started quickly.
The     early    signs   of    the    acute   disease    are:

proteinuria: large amounts of protein in the urine
hematuria:         blood         in        the          urine
reduced glomerular filtration rate: inefficient filtering of
wastes               from            the                blood
hypoproteinemia:           low        blood           protein
edema:      swelling     in    parts    of     the      body

One or more of these symptoms can be the first sign of
kidney disease. But how would you know, for example,
whether you have proteinuria? Before seeing a doctor, you
may not. But some of these symptoms have signs, or visible
manifestations.

  Signs and symptoms of kidney failure include:

     lack of appetite
     nausea and vomiting
     fatigue
     difficulty sleeping
     dry and itchy skin
     muscle cramps, especially at night.




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What causes glomerulonephritis?

Broadly we can divide the causes as follows:
A. Autoimmunity: When the body's immune system functions
properly, it creates protein-like substances called antibodies
and immunoglobulins to protect the body against invading
organisms. In an autoimmune disease, the immune system
creates autoantibodies, which are antibodies or
immunoglobulins that attack the body itself. Autoimmune
diseases may be systemic and affect many parts of the body,
or they may affect only specific organs or regions.
B. Heredity: Sometimes this disease runs in families –
This kind often shows up in young men who may also have
hearing loss and vision loss.
C. Infective : Glomerular disease sometimes develops rapidly
after an infection in other parts of the body. Acute post-
streptococcal glomerulonephritis (PSGN),HIV etc.
D. Sclerotic diseases: This means scarring of the glomeruli
by various sysytemic and local causes. Example : Diabetes,
Lupus disease etc.
E. Idiopathic – Cause of the disease is unknown.

How is       a   diagnosis of      glomerulonephritis made?
The first clues are your signs and symptoms. Finding protein
and blood cells in your urine is another sign. Blood tests will
help the doctor tell what type of illness you have and how
much it has damaged your kidneys.

Sometimes, your doctor will need to do a kidney biopsy by
taking a tiny piece of your kidney with a special needle. This
will help the doctor plan the best treatment for you.

How can glomerulonephritis be prevented?
Good hygiene, "safe sex" and avoiding IV drugs are helpful in
preventing infections that could lead to this illness.

If you have the chronic type, it is very important to control
your blood pressure since this may slow down kidney


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damage. Your doctor may tell you to eat less protein. A
dietitian who is trained to work with kidney patients (a renal
dietitian) can be very helpful in planning your diet

What    are   the      treatment    options    available    for
glomerulonephritis?

Acute Form :

 It may go away by itself. Sometimes you may need
medication or even temporary treatment with an artificial
kidney machine to remove extra fluid and control high blood
pressure and kidney failure. Antibiotics are not used for
acute glomerulonephritis, but they are important in treating
other forms of disease related to infection. If your illness is
getting worse rapidly, you may be put on high doses of
medicines that affect your immune system. Sometimes, your
doctor may order plasmapheresis, a special blood filtering
process to remove harmful proteins from your blood.

Chronic Form:

There is no specific treatment for the chronic form of the
illness. Your doctor may tell you to:

     eat less protein, salt and potassium
     control your blood pressure
     take diuretics
     take calcium supplements




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What are its complications?

  Acute nephritic syndrome

   Chronic renal failure

   End-stage renal disease

  Hypertension

  Malignant hypertension

   Fluid   overload        --   congestive       heart   failure,
pulmonary edema

  Chronic or recurrent urinary tract infection

  Increased susceptibility to other infections




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