Glomerulonephritis often comes to light when a routine urinalysis is abnormal. Tests to assess your kidney function and make a diagnosis of glomerulonephritis include:
- Urine test. A urinalysis might show red blood cells and red cell casts in your urine, an indicator of possible damage to the glomeruli. Urinalysis results might also show white blood cells, a common indicator of infection or inflammation, and increased protein, which can indicate nephron damage. Other indicators, such as increased blood levels of creatinine or urea, are red flags.
- Blood tests. These can provide information about kidney damage and impairment of the glomeruli by measuring levels of waste products, such as creatinine and blood urea nitrogen.
- Imaging tests. If your doctor detects evidence of damage, he or she may recommend diagnostic studies that allow visualization of your kidneys, such as a kidney X-ray, an ultrasound examination or a CT scan.
- Kidney biopsy. This procedure involves using a special needle to extract small pieces of kidney tissue for microscopic examination to help determine the cause of the inflammation. A kidney biopsy is almost always necessary to confirm a diagnosis of glomerulonephritis.
Treatment of glomerulonephritis and your outcome depend on:
- Whether you have an acute or chronic form of the disease
- The underlying cause
- The type and severity of your signs and symptoms
Some cases of acute glomerulonephritis, especially those that follow a strep infection, might improve on their own and require no treatment. If there's an underlying cause, such as high blood pressure, an infection or an autoimmune disease, treatment will be directed to the underlying cause.
In general, the goal of treatment is to protect your kidneys from further damage.
Therapies for associated kidney failure
For acute glomerulonephritis and acute kidney failure, dialysis can help remove excess fluid and control high blood pressure. The only long-term therapies for end-stage kidney disease are kidney dialysis and kidney transplant. When a transplant isn't possible, often because of poor general health, dialysis is the only option.
Lifestyle and home remedies
If you have kidney disease, your doctor might recommend certain lifestyle changes:
- Restrict your salt intake to prevent or minimize fluid retention, swelling and hypertension
- Consume less protein and potassium to slow the buildup of wastes in your blood
- Maintain a healthy weight
- Control your blood sugar level if you have diabetes
- Quit smoking
Coping and support
Living with a chronic illness can tax your emotional resources. If you have chronic glomerulonephritis or chronic kidney failure, you might benefit from joining a support group. A support group can provide both sympathetic listening and useful information.
To find a support group, ask your doctor for a recommendation or contact the National Kidney Foundation to find the chapter nearest you.
Preparing for your appointment
You'll likely start by seeing your primary care doctor. If lab tests reveal you have kidney damage, you might be referred to a doctor who specializes in kidney problems (nephrologist).
What you can do
To get ready for your appointment, ask if there's anything you need to do ahead of time, such as limit what you eat and drink. Then make a list of:
- Your symptoms, including any that seem unrelated to your kidneys or urinary function, and when they began
- All your medications and doses, including vitamins or other supplements that you take
- Your key medical history, including any other medical conditions and family medical history
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you're given.
For glomerulonephritis, some questions to ask your doctor include:
- How badly do my kidneys seem to be affected?
- What tests do I need?
- Is my condition likely temporary or chronic?
- Will I need dialysis?
- I have other medical problems. How can I manage them together with this condition?
- What restrictions do I need to follow?
- Should I see a specialist?
- Are there brochures or other printed material that I can have? What websites do you recommend?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- Have your symptoms been continuous or occasional?
- Does anything seem to improve or worsen your symptoms?
- Does anyone in your family have a history of glomerulonephritis or other kidney disease?
- Do you have a history of high blood pressure or diabetes mellitus?