Glomerulonephritis: Inflammation of the kidney corpuscles

Glomerulonephritis: Inflammation of the kidney corpuscles

A good one million renal corpuscles (glomeruli) in each kidney are responsible for filtering around 180 litres of primary urine from the litre of blood that flows through them every minute every day, from which almost 2 litres of final urine, including metabolic waste products, are concentrated. In addition to detoxification, the kidneys are essential for regulating water and salt balance, blood pressure regulation, formation of red blood cells and bone metabolism. Inflammatory processes can massively impair the entire kidney function.

What is glomerulonephritis?

Glomerulonephritis is an inflammation of the kidney tissue that affects both kidneys. It initially involves the kidney corpuscles but can then spread to the rest of the kidney tissue. It can be brief and severe (acute glomerulonephritis), rapidly progressing (rapidly progressive), or slow and insidious (chronic glomerulonephritis).

The immune system is usually involved. It is suspected that the constant contact of the vascular clusters in the kidney corpuscles with the pollutants in the blood leads to an inflammatory reaction. Why this is the case in some people and not in others is largely still being determined. However, scientists assume that hereditary factors play a role.

 

What forms are there?

Due to the many forms of inflammation, the disease is very diverse and can only be assessed by a kidney specialist. It is essential to distinguish the forms from one another because they progress, are treated differently, and differ in terms of their prognosis. The classification can be made based on the symptoms, the causes, the mechanism of formation and the type of tissue changes; the technical designation of the individual forms usually depends on the course and location of the primary damage (e.g. extra capillary or membranous glomerulonephritis).

  • One criterion is how the immune system is involved. In a large group, immune complexes are formed, that is, combinations of antigens and antibodies. These can arise due to other diseases (e.g. after a sore throat with streptococci) due to antibodies formed against bacterial antigens, which initially circulate in the blood and then deposit on various parts of the kidney corpuscles and damage them. In other forms, the organism forms autoantibodies against the inner layer of the kidney corpuscles deposited there. However, other immune system cells (e.g., T-cells and complements) can also trigger inflammatory reactions.
  • Another distinguishing feature is whether the inflammation initially only affects the kidneys ( primary form ) or occurs as part of systemic diseases that also affect other organs (e.g. the connective tissue in collagenosis or the lungs in Goodpasture’s syndrome), cancer, infections or in certain drugs ( secondary form ).

Symptoms and Diagnosis

Whether, how and when the disease manifests itself depends on the type of inflammation. In many cases, those affected do not feel any symptoms at all for a long time, even though the damage to the kidneys is already taking place. Later, the symptoms of progressive kidney failure appear, such as a drop in performance and feeling unwell, loss of appetite, water retention, cardiac arrhythmias and high blood pressure, but also nauseabad breathitching and yellowish skin discolouration.

Softening of the bones, increased susceptibility to infections, anaemia, impaired concentration and headaches can all occur. Some patients also complain of kidney pain. Blood, protein and so-called urinary casts can be detected in the urine, and altered kidney values ​​(creatinine) can be seen in the blood. Further examinations include an ultrasound of the kidneys and kidney function tests.

To diagnose and assign the type of inflammation, taking tissue samples from the kidneys is ultimately necessary. To make the diagnosis as early as possible and start therapy, it is essential to carry out urine tests in potential risk groups. A urine test should be carried out 1-3 weeks after a sore throat with streptococci. Even with systemic diseases that can lead to secondary G., blood and protein in the urine should be searched for at regular intervals.

 

therapy and treatment

Therapy depends on the type of inflammation. If there is an underlying disease, this is treated, e.g. tonsillitis, with antibiotics. Otherwise, antihypertensive drugs, such as cortisone and immunosuppressants, are available. Depending on the extent of the kidney failure, the person affected may have to undergo “blood washing” (dialysis) and change their diet and fluid intake.

The course varies from forms with spontaneous recovery to those with no consequences if treated early to forms in which kidney failure requiring dialysis occurs within five years or even a few months.

 

 

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