What diagnostic tests are used to confirm the diagnosis of glomerulonephritis?
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Glomerulonephritis is an inflammation of the small filters in the glomeruli. In it, platelets remove excess fluid, electrolytes and waste products from the patient's blood and pass it into the urine. Glomerulonephritis can occur alone or as a complication of another disease, such as: lupus or diabetes. Severe or prolonged illness can damage the patient's kidneys. Depending on the type of glomerulonephritis, there will be an appropriate treatment. Glomerulonephritis syndrome can appear suddenly (acute) or gradually (chronic), specifically as follows: 1.1 Acute glomerulonephritis Acute glomerulonephritis has manifestations such as back pain and hematuria , lead to oliguria or anuria. The cause of glomerulonephritis is an inflammatory and proliferative immune mechanism of the glomerulus that leads to damage to the basal membrane, mesangial vessels, or endothelium. However, acute glomerulonephritis is not a disease, but rather a syndrome of acute glomerulonephritis - a severe form of glomerular damage, with various consequences as it progresses. 1.2 Chronic glomerulonephritis Most forms of acute glomerulonephritis have a certain rate of progression to chronic. Chronic glomerulonephritis is characterized by irreversible glomerulosclerosis, tubular damage, and eventually decreased glomerular filtration rate. If the disease progresses and does not respond to treatment, it can lead to complications of chronic kidney disease, end-stage kidney disease and cardiovascular problems. As the first step in diagnosing glomerulonephritis, doctors often ask patients around questions such as: Is the frequency of symptoms constant or occasional? What improves or worsens symptoms? Is there a family history of glomerulonephritis or other kidney diseases? What is the patient's history of high blood pressure or diabetes? Glomerulonephritis is usually discovered when the patient notices many unusual signs in the passage of urine every day. Glomerulonephritis tests to evaluate kidney function and diagnose glomerulonephritis syndrome include: 2.1 Urinalysis A urinalysis can show red blood cells and a very small amount of blood present in the blood. patient's urine. This is a sign of kidney damage. Urinalysis results also help find white blood cells - common signs of infection or inflammation and increased protein. Damage to the nephron (the functional unit of the kidney) will also be detected through this indicator. Other findings, such as elevated blood creatinine or urea levels, are also notable in the diagnosis of glomerulonephritis syndrome. 2.2 Blood tests Blood tests for glomerulonephritis can help your doctor know the extent of kidney damage, as well as kidney failure. Test results are based on the concentration of waste products, such as anemia, may have increased blood urea nitrogen and creatinine. In blood tests, C3 complement is likely to be normal after about 8 weeks. Proteinuria can persist for up to 6 months, while microscopic hematuria can be up to 1 year from the time of onset of acute glomerulonephritis. The kidneys remove toxins from our bodies using tiny structures called nephrons. Each nephron contains a cluster of blood vessels called a “glomerulus” that functions as a filter, separating excess waste, fluid, and electrolytes from your blood. Show
In rare cases, these blood vessels can be damaged by a variety of causes, including genetic conditions, infection, and medications. This disrupts the kidneys’ ability to remove waste, which can lead to other complications such as high blood pressure or kidney failure. This problem is called glomerulonephritis, which although rare, can be very serious. “Treatment for glomerulonephritis needs to be started very early,” says Jeffrey Turner, MD, a nephrologist at Yale Medicine. “It should be on the top of the list of conditions a doctor should rule out if they’re looking at a patient with similar symptoms.”
Common symptoms of this condition include blood in the urine, rash, joint pains, and difficulty breathing. Blood tests typically show an issue with kidney function. In very severe cases of glomerulonephritis, the kidneys can decline very quickly and the patient might show symptoms of kidney failure such as swelling (often in legs), high blood pressure, and reduced urine.
The exact cause of this condition is not always known, but the current consensus is that an inciting event triggers an immune response in the body that sets off a chain of responses, causing inflammation of the glomeruli. Some of the known inciting events include infections such as strep throat or impetigo. Other infections that may cause glomerulonephritis include HIV and hepatitis B. Autoimmune diseases such as lupus may also cause inflammation of the glomeruli. In some cases, glomerulonephritis is caused by an inherited condition such as Alport syndrome, which is a condition that causes kidney disease, hearing loss, and eye abnormalities.
If your doctor suspects that you have glomerulonephritis, he or she will order tests that examine your urine to see if there is a high concentration of protein or inflammatory cells. Also, elevated levels of red and white blood cells in the urine are typical of glomerulonephritis, and this is a significant clue to making the diagnosis. In addition to the urine tests, your doctor may also order certain blood tests to look for markers that indicate glomerulonephritis. A kidney biopsy is typically performed to confirm the diagnosis, says Dr. Turner. Particular patterns within the tissues are what doctors are looking for; these show that the kidneys have been invaded by inflammatory blood cells.
For severe cases, it’s important to treat this condition aggressively with steroids, biologic drugs, or chemotherapy agents. Which medication is best for a particular patient depends on a number of factors including how severe the disease is and what caused it. When an infection triggers glomerulonephritis, the primary therapy focuses on treatment of the infection, rather than with drugs that suppress the immune system. For a mild case of glomerulonephritis, your doctor may only prescribe blood pressure medication to reduce pressure and damage of the arteries in the kidneys and glomerulus. They will then closely monitor the disease activity. Because this condition can lead to kidney failure, it’s crucial to treat it as quickly as possible. Once the kidneys fail, the patient will have to go on dialysis, which is a treatment that filters blood externally through a machine. “Every day that goes by increases the patient’s risk of needing dialysis,” says Dr. Turner.
Yale Medicine is home to a dedicated glomerulonephritis clinic. Physicians in this clinic collaborate closely with rheumatologists and gather monthly to discuss rare and difficult-to-treat cases. In addition, researchers in the department of nephrology are investigating underlying conditions that may affect the glomerulus, genetic testing for glomerulonephritis, and clinical trials for new drugs. This research not only gives our doctors more comprehensive and in-depth expertise about the disease, but also gives our patients access to treatments that are not yet available to the general public. Related Fact SheetsShowing 4 of 109
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