The therapy, the chances of success of the therapy and the prognosis depend largely on the form of glomerulonephritis. In most cases, immunosuppression is indicated.
General note
They are located on a subpage “Forms of glomerulonephritis“. General information on this topic can be found on our Glomerulonephritis page. Gomerulonephritis often leads to another clinical picture, which is called nephrotic syndrome.
Different shapes
Basically, the following forms can be distinguished:
- Minimal-Change Glomerulonephritis
- Endocapillary-proliferative glomerulonephritis (= Post-Streptococcal-GN)
- Mesangioproliferative glomerulonephritis of the IgA type
- Focal-segmented glomerulosclerosis
- Membranous glomerulonephritis
- Membrane-proliferative glomerulonephritis
- Necrotizing intra-/extracapillary-proliferative (= rapid progressive) glomerulonephritis
Minimal Change Glomerulonephritis
Minimal-Change-Glomerulonephritis In this variant the so-called foot cells are disturbed. As a result, the negative charge of the filter is lost and proteins are filtered. In addition to proteinuria (loss of proteins via the kidney) or albuminuria (loss of proteins via the albumin), weight gain and water retention (edema) as well as a nephrotic syndrome occur.
Typically, children between the ages of 2 – 6 years are affected. It is suspected that certain defence cells of the blood (T cells) produce and release a substance that damages the foot cells. The cause is still unknown. In rare cases, however, a connection with certain drugs, some cancers or after transplantation with stem cells has been proven. The therapy consists mainly of the administration of immunosuppressive drugs and symptomatic treatment, such as the flushing out of oedema by diuretic drugs.
Poststreptococcus glomerulonephritis acute postinfectious glomerulonephritis
In post-streptococcal glomerulonephritis acute post-infectious glomerulonephritis, the affected person develops slight fever and pain in the joints and kidney area a few weeks after infection with certain pathogens (e.g. ß-hemolytic group A streptococci). The reduced amount of urine (oligouria) is reddish brown (as a sign of blood filtration) and water retention (edema) occurs. High blood pressure is also typical.
Antigen-antibody complexes are deposited, which lead to a destruction of the filter. In the age of antibiotic therapy the prognosis is quite good. In Western Europe, the disease heals in more than 90% of children if the therapy is started and administered adequately, and in adults the rate is about 50%. If it is a different pathogen, the prognosis is worse. Non-streptococcal infections can cause post-infectious glomerulonephritis, for example, inflammation of the inner lining of the heart (endocarditis) or blood poisoning (sepsis).
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