What happens to your kidney filter? Let's learn about Glomerular Disease!

Have you ever felt like you were passing foamy urine? Or do you feel a little puffy around your face and eyes when you wake up in the morning? This could be due to a problem with the tiny filtering system in our kidneys, called the glomeruli. Today we are going to talk about this condition called Glomerular Disease.

What is Glomerular Disease?

Simply put, Glomerular Disease is a disease caused by certain conditions that affect the glomeruli, a network of tiny blood vessels in our kidneys, which are the 'filtering units' of the kidney. These glomeruli are the ones that filter waste products from our blood and remove excess fluid. So, when these glomeruli are damaged and cannot function properly, we call it Glomerular Disease.

Many diseases and conditions can damage these glomeruli. There are two main terms used to describe this damage:

• Glomerulonephritis: This is inflammation or swelling of the glomeruli.
• Glomerulosclerosis: This is the scarring or thickening of the glomeruli.

Glomerular Disease can damage your kidneys, and in some cases, even lead to kidney failure . So it's very important to be aware of this.

What do these glomeruli in our kidneys do?

Think of it this way: our kidneys are like the two main filters in our bodies. These two bean-shaped organs are located on either side of our back, just below our rib cage.

Blood enters our kidneys through arteries. Once inside the kidneys, these arteries divide further and the blood flows into a network of tiny, mesh-like blood vessels called glomeruli. Each glomerulus (one word) is connected to a small fluid collecting duct, called a tubule . We call this one glomerulus and tubule unit a nephron . It is said that there are about a million such nephrons in one kidney. Can you imagine such a delicate system!

Properly functioning glomeruli keep the blood cells and proteins in the blood system. Because they are what our body needs. At the same time, the glomeruli filter waste products and extra water and send that liquid to the tubule. That is what is later formed as urine. Then the urine passes through large tubes called ureters and collects in the bladder.

What happens to kidney function when glomerular disease develops?

Now let's see what happens when this Glomerular Disease develops. This disease damages the Glomeruli. Then they cannot function properly.

What is supposed to happen is that the proteins and red blood cells are kept in the blood. However, some of these things start to leak out in the urine from the damaged glomeruli. One of the jobs of a protein in the blood, like albumin , is to pull the extra fluid from the body into the bloodstream and help it be filtered by the kidneys and excreted as urine. So, when the amount of protein in the blood decreases, this extra fluid starts to accumulate in the body. That's why areas like the face, hands, legs, stomach, and ankles swell.

Also, damaged glomeruli are unable to filter waste properly. Then those wastes start accumulating in the blood. This is not good for the body at all.

What are the causes of Glomerular Disease?

There are several possible causes of Glomerular Disease. Let's see what they are:

• An infection, a medication or chemical that is harmful to your kidneys, or even the medication we take can affect the kidneys.
• Diseases that affect the entire body, including those that affect the kidneys. For example , diabetes mellitus or lupus .
• Diseases that cause swelling or scarring of the nephron or glomerulus.
• Sometimes, it may not be possible to find a reason. There are times like that.

What are the symptoms of Glomerular Disease?

Okay, now let's see what the symptoms of this disease are. If you have one or more of these symptoms, you should be concerned:

• Foamy urine: This means there is protein in your urine. We call this proteinuria .
• Pink or light brown urine: This means there is blood in the urine. This is called hematuria .
• Swelling around the face/eyes (especially in the morning), hands, feet, or ankles (especially at the end of the day). This swelling is called edema .
• High blood pressure (Hypertension).

If you have symptoms like these, it is best to definitely see a doctor and seek advice.

How do doctors accurately diagnose this disease?

When you go to a doctor, they will first ask you about your symptoms and examine you carefully. Then they may do some tests, such as:

• Urinalysis:This checks the protein level in the urine, whether there are red blood cells, and how the white blood cell level is (this can help determine if there is an infection or inflammation).
• Blood tests: These check for low protein levels in the blood, creatinine levels (which give an idea of ​​kidney function), and urea nitrogen levels (a waste product). They also calculate the Glomerular Filtration Rate (GFR) , which is a measure of how well your kidneys are filtering waste.

If these lab tests show that your kidneys are damaged, your doctor may order further tests:

• Other blood tests: To check for infections or autoimmune diseases.
• Imaging tests: A test such as an ultrasound can check for any abnormalities in the shape or size of the kidneys.
• Kidney Biopsy: This involves taking a small piece of tissue from the kidney using a needle and looking at it under a microscope. This will help determine exactly what is wrong.

Various conditions and treatments that cause Glomerular Disease

Many diseases can cause Glomerular Disease. The main goal of treatment is to find the underlying cause and treat it, if possible. This can prevent further damage to the kidneys. Let's now look at some of the main diseases that cause Glomerular Disease, along with examples and treatments.

Autoimmune Diseases

These are diseases in which your body's immune system attacks your own body. These diseases can affect the entire body, or they can affect only certain organs in the body. Here are some autoimmune diseases that affect the kidneys:

• Systemic Lupus Erythematosus (SLE) (also known simply as lupus): This autoimmune disease can affect many parts of the body. When it affects the kidneys, it causes a condition called lupus nephritis . This is an inflammation of the glomeruli. This inflammation causes scarring and the kidneys to stop working properly. Treatment includes immunosuppressive drugs such as Mycophenolate Mofetil or Cyclophosphamide , along with a corticosteroid called Prednisolone .
• Goodpasture's Syndrome:This autoimmune disease attacks the kidneys and lungs. In the kidneys, it causes glomerulonephritis, which is inflammation of the glomeruli. This can cause permanent damage to the kidneys. Treatment includes immunosuppressive drugs and plasmapheresis (which removes antibodies that are attacking your own body) .
• IgA Nephropathy: In this autoimmune disease, an antibody called Immunoglobulin A (IgA) from your immune system deposits itself in the glomeruli. These deposits cause inflammation. Treatment includes medications such as Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors) or Angiotensin Receptor Blockers (ARBs) .

Hereditary Nephritis

• Alport Syndrome: This is a hereditary condition. It can cause hearing or vision loss along with chronic glomerular disease. It affects both men and women. Men are more likely to develop chronic kidney disease. It can be diagnosed in their twenties. By the age of 40, the kidneys may be completely dysfunctional. Medications to control blood pressure are the treatment.

Infection-related Glomerular Disease

Sometimes, glomerular disease can develop quickly after an infection elsewhere in the body.

• Acute Post-Infectious Glomerulonephritis (PIGN): This glomerular disease occurs after a throat infection (Strep throat) or a skin infection called Impetigo (this is rare). The immune system produces more antibodies than necessary to fight the infection. These antibodies go and deposit in the glomeruli and damage them. In most cases, no special treatment is needed. However, in rare cases, kidney dialysis or a kidney transplant may be necessary.
• Bacterial Endocarditis: This is an infection of the lining of the heart. Researchers are not yet sure whether the lesions in the kidneys are caused by the immune system's response to the infection or by some other disease mechanism. Antibiotics are given as treatment.
• Viruses: Hepatitis B , Hepatitis C andGlomerular disease can also be caused by viral infections such as the Human Immunodeficiency Virus (HIV). Specific treatments are available for each disease.

Sclerotic Diseases - Diseases that cause scarring

• Glomerulosclerosis: This condition is the scarring (sclerosis) of the glomeruli. Lupus and diabetes are two examples of diseases that can cause glomerulosclerosis.
• Diabetes-related Nephropathy: This is the leading cause of glomerular disease and total kidney failure in the United States. Diabetes-related nephropathy causes scarring of the kidneys and increases glucose levels. Glucose increases blood flow to the kidneys, putting strain on the glomeruli's filtration function and increasing blood pressure. Common treatments include blood pressure medications (especially angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) ), exercise, and a healthy diet.
• Focal Segmental Glomerulosclerosis (FSGS): This condition is characterized by scarring (usually) in one part of a glomerulus. FSGS can be caused by a systemic disease or by no known cause. Treatment is aimed at lowering blood pressure and cholesterol levels.

Other Glomerular Diseases

• Membranous Nephropathy: This condition is also called Membranous Glomerulopathy . It is the second most common cause of nephropathy in adults in the United States, after diabetes-related nephropathy. It is associated with certain target antigens/antibodies . This condition attacks the membrane layer of the glomeruli. Some people recover without treatment. Medications such as angiotensin-converting enzyme inhibitors (ACE inhibitors) , angiotensin receptor blockers (ARBs) , or calcineurin inhibitors are sometimes tried.
• Minimal Change Disease (MCD): This is a type of nephropathy. In this, when examined in a kidney biopsy, there is almost no change in the structure of the glomeruli or the surrounding tissues. Lipids (fatty substances)There may be dropsy, but there is no kidney damage. MCD can develop at any age, but is most common in young children. Treatment includes a low-salt diet and ACE inhibitors or ARBs . Steroids often improve the condition.

Can glomerular disease cause kidney failure?

Yes, if your kidneys are unable to remove waste products from your blood, they build up in your body. This build-up can damage your kidneys and cause them to stop working. This loss of function can happen suddenly (acute) or slowly and continuously (chronic). Depending on the type of glomerular disease, kidney function can be lost in a matter of days or weeks, or it can take decades to gradually disappear.

• Acute Renal Failure (ARF): This is the sudden loss of kidney function. ARF can be life-threatening, and dialysis may be needed as an emergency treatment to restore kidney function. For some people, kidney function returns after the cause of the kidney failure is treated. There is no permanent damage. However, some people who recover from ARF may later develop chronic kidney disease (CKD) .
• Chronic Kidney Disease (CKD): This is a slow, gradual loss of kidney function. You may not have any symptoms for years. Some of the diseases that cause CKD can be controlled, but CKD cannot be cured. Once the kidneys are damaged, they cannot be repaired. CKD can lead to complete kidney failure.
• Total Kidney Failure: Also called End-Stage Renal Disease (ESRD) . This means that your kidneys have permanently lost function. If you have total kidney failure, you will need dialysis - either hemodialysis or peritoneal dialysis - or a kidney transplant to survive.

What should I expect if I have Glomerular Disease?

Early diagnosis and early treatment are always the best options for achieving the best results. The goal of treatment is to either prevent kidney damage or control its progression. Remember, early detection can help. If the damage is severe and the kidneys fail, the only options are dialysis or a kidney transplant.

Can Glomerular Disease be prevented?

There are several lifestyle changes you can make to reduce your risk of developing diseases that affect your kidneys and stay healthy. These include:

• Maintain a healthy weight.
• Reduce salt consumption; do not add extra salt to food.
• Keep your blood pressure under control. The target is 120/80 mmHg.
• If you have diabetes, control your blood sugar levels.
• Take all medications prescribed by your doctor exactly as prescribed, and follow all management goals discussed with him.
• Quit smoking.

Not all causes of glomerular disease can be prevented. However, as soon as you start to notice symptoms of glomerular disease, see a doctor. It is important to find treatable causes and start treatment as soon as possible. Treatment can help control the damage to your kidneys and prevent it from getting worse.

What is Nephrosis or Nephrotic Syndrome?

Nephrosis, also known as nephrotic syndrome, is a collection of symptoms. A large amount of protein in the blood is excreted in the urine. This causes fluid to accumulate in the body. The symptoms are:

• Swelling (edema), especially around the eyes, legs and arms.
• High blood pressure.
• High cholesterol levels.
• Decreased protein levels in the blood.
• Increased protein levels in the urine.

The goal of treatment is to treat the underlying cause, if possible. Treatment includes:

• Angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) are given to control blood pressure and stop protein from passing into the urine.
• Reduce salt in your diet.
• Diuretics are given to reduce fluid retention in the body.
• Corticosteroids or other immune-suppressing medications are given.
• Medication is given to lower cholesterol levels.
• If you have an autoimmune disease, plasmapheresis is performed to remove antibodies that are attacking your own body.

If the underlying cause of nephrosis is kidney disease, it cannot be cured. Because the glomeruli in the kidneys do not function properly, waste products and water accumulate in the blood. The kidneys fail. When the disease worsens, the treatment is either dialysis or a kidney transplant.

When should I see a doctor?

If you have signs or symptoms of Glomerular Disease, or if you notice any changes in your health, be sure to see a doctor. Don't ignore even the smallest thing, because the earlier you find out, the easier it is to treat.

Various diseases and conditions can damage the glomeruli in your kidneys. It's important to be aware of your body so that you can see a doctor as soon as possible if you notice any changes.

The most important things to remember from this article (Take-Home Message)

Okay, so now you have a good understanding of what we've been talking about, Glomerular Disease. Here are some key things to remember:

• Glomerular disease is a condition caused by damage to the filtering units (glomeruli) of the kidneys.
• Be aware of symptoms like foaming urine, blood in urine, swelling, and high blood pressure. If you notice these, see a doctor immediately.
• If you have diseases like diabetes and hypertension, it is very important to control them well to protect your kidneys.
• If the disease is detected early, treatment can control the damage to the kidneys. So don't ignore any symptoms.
• Maintaining a healthy lifestyle (eating well, exercising, and avoiding smoking) helps protect against these types of diseases.

Your kidneys are two of the most important organs in your body. Take care of them. If you have any problems, don't be afraid to talk to a doctor, okay?

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