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Patient education: Glomerular disease

  • vistasmed
  • Jun 21, 2019

What is glomerular disease?Glomerular disease is a condition that affects the kidneys. The kidneys are organs in the urinary tract that make urine (figure 1).

 Anatomy of the urinary tract

Urine is made by the kidneys. It passes from the kidneys into the bladder through two tubes called the ureters. Then it leaves the bladder through another tube called the urethra.

 Each kidney has 2 parts:

  • A part that filters the blood and removes waste and excess salt and water
  • A part that collects urine

In glomerular disease, the part of the kidney that filters the blood doesn't work normally. As a result, substances that shouldn't be in the urine, such as blood and protein, can get into the urine.

Glomerular disease can happen quickly or slowly over time. There are different types of glomerular disease, and each type has different causes.

Sometimes glomerular disease causes serious problems. It can cause acute kidney failure, which is when the kidneys suddenly stop working. It can also cause chronic kidney disease, which is when the kidneys slowly stop working.

What are the symptoms of glomerular disease?The symptoms depend on the type of glomerular disease you have and what's causing it. Some people with glomerular disease have no symptoms. They find out they have it when their doctor does a urine test for another reason.

When glomerular disease causes symptoms, they can include:

  • Bloody urine or urine that is red, pink, or brown
  • Swelling of the hands, face, feet, or belly
  • Feeling tired
  • Urinating less than usual

Is there a test for glomerular disease?Yes. Your doctor or nurse can check for glomerular disease by doing blood and urine tests. These tests can show if your urine has blood or protein in it, and how well your kidneys are working.

Your doctor or nurse will probably do other tests to find out which type of glomerular disease you have. These tests can include:

  • Blood tests to check for medical conditions that can cause glomerular disease
  • An ultrasound of your kidney – An ultrasound is an imaging test that uses sound waves to create a picture of the kidney.
  • A kidney biopsy – During a biopsy, the doctor will put a thin needle into your back and into your kidney. He or she will remove a tiny sample of tissue from the kidney. Then another doctor will look at the sample under a microscope.

How is glomerular disease treated?Treatment depends on your symptoms, what's causing your glomerular disease, and how quickly it happened.

People with mild glomerular disease might not need treatment. But their doctor will do blood and urine tests over time to follow their condition.

Some types of glomerular disease go away on their own. For instance, people can get glomerular disease after they have an infection in another part of their body. This type of glomerular disease usually goes away after the infection is treated.

When glomerular disease does need to be treated, treatments can include:

  • Medicines called steroids – These steroids are different from the ones athletes take to build muscle. These medicines can come as pills or go into a vein through a thin tube, called an "IV."
  • Strong medicines that partly "turn off" the immune system, such as cyclophosphamide (brand name: Procytox) or azathioprine (sample brand names: Azasan, Imuran) – These medicines (also called "immunosuppressive medicines") can be taken along with steroid medicines.
  • Medicines that treat high blood pressure
  • Medicines called "diuretics" that make people urinate a lot
  • Plasmapheresis – For this treatment, a machine pumps blood from your body and filters out substances that are harming your kidney. Then the machine returns the blood to your body.

People whose kidneys have stopped working might need other treatment called "renal replacement therapy." Renal replacement therapy includes 3 different treatments that can do the work of the kidneys. These treatments are:

  • Hemodialysis – Hemodialysis is a procedure in which a machine pumps blood out of the body, filters it, and returns it to the body (figure 2). People have hemodialysis at least 3 times a week. Hemodialysis

This drawing shows a person getting hemodialysis. Two needles are put into an "access" in the person's arm. Blood flows from the body to the hemodialysis machine, where it is filtered. Then the blood is returned to the body. The whole process takes about 3 to 5 hours and must be repeated 3 to 7 times a week.

  • Peritoneal dialysis – Peritoneal dialysis is a procedure that people do at home every day. It involves piping a special fluid through a tube into the belly. This fluid collects waste and excess salt and water from the blood. Then the used fluid drains out of the belly (figure 3). Peritoneal dialysis

This drawing shows a person having peritoneal dialysis. The dialysis fluid (fresh dialysis solution) flows into the person's belly. It stays there for a certain amount of time, and then it drains out into the drain bag. The "transfer set" is the tubing that connects a thin tube (catheter) in the person's belly to the dialysis equipment.

  • Kidney transplant – A kidney transplant is surgery in which a doctor puts a healthy kidney in a person whose kidneys are diseased (figure 4). Kidney transplant

This drawing shows a person who has had a kidney transplant. The new kidney is put in the lower part of the belly. The kidney's ureter (the tube that carries urine from the kidney to the bladder) is connected to the person's bladder. In many cases, the diseased kidneys are left in place.



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