Glomerulonephritis
Glomerulonephritis is a group of conditions in which the kidney's filtering units (glomeruli) become inflamed. The inflammation can be mild and self-limiting, or it can be aggressive and rapidly damaging. Specialist input is important from the outset because the right diagnosis determines the right treatment, and the right treatment can mean the difference between full recovery and progressive kidney damage.
Dr Rory McQuillan provides consultant-led assessment and management of glomerulonephritis across all forms, with full diagnostic workup including kidney biopsy where indicated.
What is glomerulonephritis?
Glomerulonephritis describes inflammation of the glomeruli, the tiny structures in each kidney that filter blood. There are many different types, classified by their cause, their appearance under the microscope, and the pattern of damage they produce. Common subtypes include IgA nephropathy, membranous nephropathy, focal segmental glomerulosclerosis, minimal change disease, lupus nephritis, ANCA-associated vasculitis, and anti-GBM disease.
Symptoms and presentation
Glomerulonephritis presents in several recognisable patterns. The main ones are:
- Nephritic syndrome: blood in urine, high blood pressure, reduced kidney function
- Nephrotic syndrome: heavy protein loss in urine, swelling, low blood albumin
- Rapidly progressive glomerulonephritis: rapid decline in kidney function over weeks
- Asymptomatic urinary abnormalities: blood or protein detected on routine testing
How glomerulonephritis is diagnosed
Diagnosis combines clinical assessment with laboratory tests, immunology, and very often a kidney biopsy. Specialist tests include:
- Urinalysis and quantification of proteinuria
- Blood tests including kidney function, full blood count, and inflammatory markers
- Immunology screen: ANA, ANCA, anti-GBM, complement levels, immunoglobulins
- Hepatitis B, C, and HIV serology
- Kidney biopsy under ultrasound guidance, often the only way to confirm the exact diagnosis
Treatment options
Treatment is dictated by the specific type of glomerulonephritis. Options range from observation in mild cases to immunosuppressive therapy in aggressive disease. Treatments may include corticosteroids, cyclophosphamide, mycophenolate, rituximab, and newer biologic agents. Blood pressure control, proteinuria reduction with ACE inhibitors or ARBs, and cardiovascular risk management are central across all subtypes.
Long-term care
Most types of glomerulonephritis are long-term conditions even when they respond to treatment. Long-term care involves monitoring for relapse, adjusting immunosuppression, managing the side effects of medication, and protecting cardiovascular health. Many patients are eventually able to come off active treatment and continue with monitoring alone.
Appointments
Glomerulonephritis is a condition where specialist input matters from the start. Appointments are arranged through GP referral.
Frequently Asked Questions
Most patients with suspected glomerulonephritis will need a biopsy to establish the exact diagnosis. The procedure is performed under ultrasound guidance and is generally safe and well tolerated.
Most types are not directly inherited, although there is a genetic susceptibility for some forms. Family history will be discussed at consultation.
Some forms can resolve completely, particularly when treated early. Others are chronic but controllable with the right therapy. The outlook depends on the specific subtype and the response to treatment.
Many patients require long-term immunosuppression. Others can be managed with blood pressure medication and monitoring alone. The plan is individualised.
Have a Question?
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Please note: Appointments are arranged via GP referral.