Glomerular disease refers to a group of conditions that affect the glomeruli, the tiny filtering units within the kidneys responsible for removing waste and excess fluids from the blood. These conditions can disrupt the kidneys' ability to filter properly, leading to symptoms such as swelling (edema), the presence of protein or blood in the urine (proteinuria/hematuria), and a decline in kidney function. Depending on the cause and severity, glomerular diseases may progress to chronic kidney disease if left untreated.
The first step in managing glomerular disease is an accurate diagnosis. This often involves blood and urine tests to detect abnormalities, as well as a renal biopsy, where a small sample of kidney tissue is examined under a microscope. The biopsy helps determine the underlying cause, which can range from autoimmune disorders like lupus nephritis to infections, diabetes, or other systemic diseases. A precise diagnosis is essential to tailor the treatment plan to the specific type of glomerular disease.
Treatment typically involves addressing the underlying cause while controlling symptoms and preventing further kidney damage. For immune-mediated glomerular diseases, immunosuppressive therapies such as corticosteroids or other medications may be prescribed to reduce inflammation and prevent immune attacks on the kidneys. Blood pressure control, often with ACE inhibitors or ARBs, is crucial to protect the glomeruli and reduce protein loss in the urine. In some cases, medications to manage swelling and prevent blood clots, such as diuretics and anticoagulants, may also be required.
Lifestyle changes, such as following a low-sodium, kidney-friendly diet, maintaining a healthy weight, and avoiding nephrotoxic medications, are important aspects of care. With early detection and appropriate treatment, many glomerular diseases can be controlled or even cured. For more advanced cases, close monitoring by a nephrologist and regular follow-ups are critical to managing the condition effectively and preventing progression to chronic kidney disease.
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