Comprehensive, Team-Based Care for Glomerular Disease

Causes and Risk Factors for Glomerular Disease

The most common cause of glomerular disease is diabetic kidney disease. Less common causes include:

• Autoimmune diseases including lupus or vasculitis, conditions which cause the body’s immune system to attack its own cells and tissues.
• Genetic kidney disorders like Alport syndrome, an inherited type of kidney disease caused by a defective gene.
• Infections such as strep throat or impetigo, hepatitis B or C, or HIV.
• Chronic use of certain medications including nonsteroidal anti-inflammatory drugs (NSAIDs).

Signs and Symptoms of Glomerular Disease

Glomerular diseases can vary from mild to very serious and may not present with obvious symptoms. Common warning signs include:

• Foamy urine, which may indicate the presence of excess protein (albumin) in the urine.
• Pink or brownish-red colored urine, which may indicate the presence of blood in the urine.
• Swelling of the face, hands and legs, which may be a sign of excess fluid retention.

Patients with any combination of these symptoms should be evaluated by a doctor to confirm or rule out a diagnosis of glomerular disease.

Diagnosis of Glomerular Disease

An early and precise diagnosis of glomerular disease is essential to avoid disease progression and potential kidney failure. While some forms of the disease can take years or decades to progress, others may develop quickly in just weeks or months. Therefore, a prompt and accurate diagnosis is essential so that treatment can begin. To diagnose glomerular disease, one or more of the following tests may be done:

• Urine studies to test for the presence of blood, protein or white blood cells in the urine.
• A blood test called glomerular filtration rate (GFR) which measures how well the kidneys are filtering the blood.
• Blood test to look for excess waste products (urea and creatinine) in your blood.
• Blood test to look for low blood protein (albumin) levels.
• Imaging tests such as CT or ultrasound scans to look at the size and shape of the kidneys.
• Kidney biopsy – the removal of a small sample of kidney tissue for examination.

The results of the diagnostic tests can help determine the cause of glomerular disease and the most appropriate treatment plan.

Treatments to Slow Disease Progression

Glomerular disease has many potential causes, so treatment is individualized for each patient. Depending on the cause of the disease, treatments may include:

• Treatment of any underlying infection.
• Medical management of high blood pressure.
• Water pills to help eliminate extra body fluid.
• Medicine to suppress the immune system, such as glucocorticoid (steroids).
• Medically supervised dietary and exercise plans.

If glomerular disease is advanced and does not respond to treatment, dialysis or kidney transplant may be required.

Some patients may have the option of participating in a clinical trial, if one is available. The nephrologists at University Hospitals are involved in cutting-edge research related to chronic kidney disease, high blood pressure, kidney transplantation and other areas of nephrology. We also participate in national clinical trials that give patients access to innovative new treatment options.

Can Glomerular Disease Be Prevented?

Although it isn't always possible to prevent glomerular disease, there are ways to lower your risk, including:

• Get regular physical exams that include bloodwork to monitor and measure kidney function.
• Monitor your blood pressure and follow your doctor’s recommendations to manage it.
• If you have diabetes, follows your doctor’s orders to keep blood sugar levels under control.
• Seek prompt treatment for any infections.
• Practice safe sex and avoid IV drug use to prevent infections like hepatitis and HIV.

University Hospitals’ Glomerular Disease Program includes a multidisciplinary team of specialists who work together to diagnose, treat and provide follow-up care to patients with glomerular disease.

Pharmacy

Emily Acheson, PharmD