Chronic glomerulonephritis refers to long-term inflammation and damage to the glomeruli, which are the filtering units of the kidneys. When chronic glomerulonephritis progresses to severe renal damage, it indicates significant impairment of kidney function, potentially leading to chronic kidney disease (CKD) or end-stage renal disease (ESRD).
The severity of renal damage in chronic glomerulonephritis can vary depending on factors such as the underlying cause, the extent of glomerular injury, and the presence of comorbidities. Severe renal damage may manifest as:
- Decline in Kidney Function: Progressive loss of kidney function, characterized by a decrease in glomerular filtration rate (GFR) and impaired ability to filter waste products and excess fluids from the blood. This decline in kidney function can lead to the accumulation of toxins and waste products in the body, resulting in uremia (uremic syndrome).
- Proteinuria: Damage to the glomeruli can lead to increased permeability of the filtration barrier, allowing proteins such as albumin to leak into the urine (proteinuria). Persistent proteinuria is a hallmark feature of chronic glomerulonephritis and can contribute to further kidney damage and complications.
- Hypertension: Chronic glomerulonephritis can disrupt the regulation of blood pressure by the kidneys, leading to hypertension (high blood pressure). Hypertension, in turn, can exacerbate kidney damage and increase the risk of cardiovascular complications.
- Fluid and Electrolyte Imbalance: Impaired kidney function can disrupt the balance of fluids, electrolytes (such as sodium, potassium, and calcium), and acid-base levels in the body, leading to edema (fluid retention), electrolyte abnormalities, and metabolic acidosis.
- Renal Insufficiency or Failure: In severe cases, chronic glomerulonephritis can progress to renal insufficiency or failure, where the kidneys are no longer able to adequately perform their essential functions. This may necessitate renal replacement therapy, such as dialysis or kidney transplantation, to sustain life.
Management of chronic glomerulonephritis with severe renal damage typically involves a combination of interventions aimed at slowing the progression of kidney disease, managing complications, and preserving remaining kidney function. This may include medications to control blood pressure, reduce proteinuria, and manage symptoms, as well as lifestyle modifications and dietary changes to support kidney health.
Regular monitoring of kidney function, including blood tests (e.g., serum creatinine, GFR) and urine tests (e.g., proteinuria), is essential for assessing disease progression and guiding treatment decisions. In advanced stages of kidney disease, renal replacement therapy may be necessary to maintain quality of life and prevent life-threatening complications.