What are the main symptoms and signs of the glomerulonephritides?
Last updated: Monday, June 02, 2008
Despite its many causes, glomerulonephritis has a fairly limited spectrum of presentations, ranging from no symptoms at all to life-threatening.
It is important to note that the above classifications do not equate to specific symptoms and signs. Different diseases and histological subtypes can have similar presentations and conversely the same pathology (both aetiological and histological) can present in different ways in different patients. Even in one particular patient, different presentations are sometimes observed at different times in their life.
Advertisement
It is therefore easier to divide the presentation of glomerulonephritis into ‘renal syndromes’ (groups of symptoms and signs), than to comprehend the different histological and aetiological subtypes.
The five main renal syndromes are:
The nephritic syndrome is characterised by blood in the urine (haematuria) and a high blood pressure. The urine of is often described as ‘smoky’ or even ‘coke coloured’. Sometimes blood is only detectable by looking at the urine under the microscope. Patients may also complain of a decreased volume of urine (oliguria), oedema (swelling) and they may be feeling generally unwell and weak. A limited amount of protein can be detected in the urine. Patients may rarely present with symptoms similar to those of renal failure.
The nephrotic syndrome is defined by heavy proteinuria (the detection of protein in abnormally high concentrations in the urine), a low concentration of the main form of protein in the blood, namely albumin (hypoalbuminaemia), and oedema (swelling). Patients usually first notice swelling of the feet, the lower legs and later around the eyes. The nephrotic syndrome can occur with or without renal failure, hypertension (high blood pressure) and haematuria (blood in the urine). Sometimes the complications of this syndrome dominate the picture.
Examples are a predisposition to infections, a raised level of blood cholesterol leading to premature atherosclerosis (with strokes and heart attacks) and venous thrombosis (‘blood clots’).
Asymptomatic proteinuria (protein in the urine), haematuria (blood in the urine) or both are found quite frequently when healthy individuals are screened for insurance or other routine purposes. These patients may remain asymptomatic for many years and recover spontaneously, or may progress to the other renal syndromes.
Rapidly progressive renal failure is an aggressive form of glomerulonephritis sometimes associated with acute renal failure. Patients may have oedema, shortness of breath, convulsions and cardiac arrhythmias or many other complaints.
Chronic renal failure can be the end result of many forms of glomerulonephritis that went unnoticed by the patient or doctor. Patients are usually hypertensive, have varying degrees of proteinuria and complain of symptoms of chronic renal failure, such as a decreased effort tolerance, loss of energy and libido (sexual drive), a dry pale skin or many other non-specific complaints.
Bookmark with:
What are social bookmarks?