Glomerular diseases damage the glomeruli, the tiny filters in the kidney. When they are inflamed or scarred they leak protein and blood into the urine and may lose filtering capacity. The term glomerulonephritis is used when inflammation is the main process.
The group includes IgA nephropathy, minimal change disease, focal segmental glomerulosclerosis (FSGS), membranous nephropathy, lupus nephritis, ANCA vasculitis and diabetic kidney disease. They range from mild and slow to rapidly destructive, which is why an exact diagnosis, usually by biopsy, matters.
Symptoms
- Foamy or frothy urine
- Swelling of ankles, legs or around the eyes, worse in the morning
- Pink, red or cola-coloured urine
- High blood pressure
- Tiredness and reduced urine output
- Weight gain from fluid
- Often no symptoms, with protein or blood found at a routine check
Causes and risk factors
Many forms are autoimmune: the immune system deposits antibodies or immune complexes in the filters (IgA nephropathy, membranous nephropathy with anti-PLA2R antibodies, lupus) or attacks small vessels (ANCA vasculitis, anti-GBM disease). Others follow infections such as streptococcal throat infection, hepatitis B or C, or HIV. Diabetes and long-standing hypertension damage the glomeruli through pressure and metabolic injury. FSGS can be genetic, related to obesity or a reduced number of nephrons, or caused by a circulating factor. Some drugs, including NSAIDs, and some cancers can also trigger glomerular disease.
How it is diagnosed
- Urinalysis and urine protein to creatinine ratio: Confirms and measures blood and protein leakage.
- Blood tests: Kidney function, albumin, cholesterol, complement levels, ANA, anti-dsDNA, ANCA, anti-GBM, anti-PLA2R, hepatitis and HIV serology.
- Kidney ultrasound: Checks kidney size and excludes other causes before biopsy.
- Kidney biopsy: The definitive test; shows the pattern under light, immunofluorescence and electron microscopy and guides treatment.
Treatment options
- Blood pressure and protein-lowering drugs: ACE inhibitors or ARBs, and increasingly SGLT2 inhibitors, form the base for almost every type.
- Corticosteroids: First-line treatment for minimal change disease and used in several other types.
- Immunosuppressants: Rituximab, cyclophosphamide, mycophenolate or calcineurin inhibitors chosen according to the biopsy diagnosis.
- Newer targeted drugs: Targeted-release budesonide and sparsentan for IgA nephropathy where available; complement inhibitors for certain rare diseases.
- Plasma exchange: For anti-GBM disease and selected severe vasculitis.
- Supportive care: Salt restriction, diuretics, statins, vaccination and sometimes blood thinners when albumin is very low.
When it is urgent
Seek emergency care near you for a sudden drop in urine output, dark urine with rapidly rising swelling, coughing blood, severe breathlessness, a severe headache with very high blood pressure, or a painful swollen leg.
Travelling to Türkiye for treatment
Treatment runs over months to years with frequent blood tests and adjustment of immunosuppression, so the main care should be local. Travelling can make sense for a kidney biopsy read by an experienced renal pathologist, for a second opinion on a treatment plan, or for review of biopsy slides you bring with you. Do not travel during a rapidly progressive phase.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Will I end up on dialysis?
Many people never do. The outlook depends on the type, the amount of protein leak, blood pressure control and how early treatment starts.
Do I always need a biopsy?
Not always. Children with typical nephrotic syndrome, people with long-standing diabetes and typical findings, and some adults with positive anti-PLA2R antibodies may be treated without one.
Can a slide review be done without repeating the biopsy?
Often yes. Ask your hospital for the paraffin blocks and slides and the full report.
Is a special diet needed?
Lower salt is the most important measure. Very high protein diets should be avoided; severe protein restriction is not routinely advised.