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What’s Glomerular Disease?

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Glomerular disease damages the blood-filtering units of the kidney, leading to irreversible kidney damage and end-stage renal disease. Glomerulonephritis and glomerulosclerosis are the two categories of kidney disorders that cause destruction of the glomeruli. Autoimmune, hereditary conditions, and infections can cause the development of glomerular disease. Glomerulosclerosis is usually caused by sclerotic diseases such as diabetes.

Glomerular disease refers to a group of disorders that attack the blood-filtering units of the kidney, called the glomeruli. Kidney disorders involving destruction of the glomeruli fall into two categories. The first category is called glomerulonephritis and the second is called glomerulosclerosis. Both subsets of glomerular disease can cause irreversible kidney damage that can lead to end-stage renal disease (ESRD).

Medical conditions that cause inflammation of the glomeruli and related kidney structures are referred to as glomerulonephritis or glomerular nephritis. In glomerulonephritis, acute and chronic inflammation damages the glomeruli and important structures in the kidney. As a result, kidney damage will hamper the filtration of waste products, allowing toxins to build up in the blood. The most common symptoms of glomerulonephritis are foamy urine, blood in the urine, and edema or swelling.

Autoimmune, hereditary conditions, and some infections can cause the development of glomerular disease, particularly glomerulonephritis. Systemic lupus erythematosus (SLE), Goodpasture syndrome, and immunoglobulin A (IgA) nephropathy are usually the most common autoimmune conditions affecting the kidneys. In each of the above autoimmune disorders, the body produces harmful autoantibodies which lodge in the glomeruli causing inflammation. Ultimately, inflammation of the glomeruli usually leads to scarring and impaired kidney function.

Alport syndrome is an inherited condition that can cause chronic glomerular disease. In general, men with the syndrome are more likely to suffer from kidney failure than women. Unlike Alport syndrome, anyone can develop a bacterial infection that leads to kidney disease. A bacterial infection such as acute post-streptococcal glomerulonephritis (PSGN) can develop after an episode of strep throat or impetigo. Much like autoimmune disorders, PSGN damages the kidneys by overstimulating the immune system to produce antibodies that eventually deposit in the glomeruli.

In glomerulosclerosis, the glomeruli and surrounding structures in the kidneys harden and scar. Once scarring has occurred, the damage to the kidneys is irreversible. As a result, scarring of the glomeruli causes a disruption in the filtering process of the kidneys. The condition usually progresses until the patient experiences ESRD. Symptoms such as proteinuria, which is excessive protein secretion, usually do not arise until the glomerular disease has progressed significantly.

Glomerulosclerosis is usually caused by sclerotic diseases such as diabetes. Uncontrolled diabetes is characterized by an increase in blood sugar. Over time, patients with uncontrolled diabetes will most likely develop nephropathy of the kidneys. Diabetes-induced nephropathy damages the kidneys by scarring and straining the tiny blood vessels in the kidneys. The rate of progression in diabetic nephropathy can be minimized by controlling blood glucose levels and lowering blood pressure.

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