How many have people glomerular disease?
The prevalence of glomerular disease in the general population is difficult to assess because optimal conditions for conducting epidemiologic surveys are elusive. However, recent studies from Europe and Australia suggest that the pattern of glomerular disease in the general population has changed, and focal segmental glomerulosclerosis is becoming more common in black and Hispanic populations. Glomerular disease is an important cause of acute kidney injury (AKI) and accounts for approximately 15% of end-stage renal disease (ESRD).
How is glomerular disease treated?
As with general CKD, the first step in treating glomerular disease is to control hypertension. For infectious diseases, treatment is aimed at eliminating the infectious agent. For autoimmune diseases, immunosuppressive drugs and "blood purification therapy" (plasmapheresis) are used to remove autoantibodies. Some patients are treated with corticosteroid therapy (e.g., minimal change disease and lupus nephritis). Diuretics are recommended for patients who have swelling due to changes in fluid homeostasis. With good management of hypertension and other underlying disease factors, renal dysfunction and other complications can be prevented or delayed. Because of the reservoir of nephrons, patients are usually not diagnosed until the disease has progressed. Patients who reach end-stage renal disease require dialysis or kidney transplantation.
What are the symptoms of glomerular disease and how is it diagnosed?
Signs and symptoms of glomerular disease include:
- Albuminuria: large amounts of protein in the urine
- Hematuria: blood in the urine
- Decreased glomerular filtration rate: inefficient filtering of waste from the blood
- Hypoproteinemia: low blood protein levels
- Edema: swelling in parts of the body
One or more of these symptoms may be the first sign of kidney disease.
Patients with glomerular disease have significant amounts of protein in their urine, which can be referred to as a "nephrotic area" if the levels are very high. Red blood cells in the urine are also a common finding, especially in some forms of glomerular disease.
Urinalysis provides information about kidney damage by showing the levels of proteins and red blood cells in the urine. Blood tests measure levels of waste products such as creatinine and urea nitrogen to determine if the kidneys' filtering capacity is impaired. If these lab tests indicate kidney damage, the doctor may recommend an ultrasound or X-ray to see if the shape or size of the kidneys is abnormal. These tests are called renal imaging.
However, because glomerular disease causes problems at the cellular level, the doctor is also likely to recommend a kidney biopsy - a procedure in which small pieces of tissue are removed with a needle and examined with different microscopes, each showing a different aspect of the tissue. A biopsy can be helpful in confirming glomerular disease and identifying the cause.