If you are diagnosed with glomerulonephritis, the healthcare professional treating you will focus on treating the cause of the condition as well as the symptoms.
Dietary changes
You may be advised to:
- drink less fluids
- reduce your intake of food or drinks that contain a high amount of sodium chloride (salt) or potassium
Sodium chloride and potassium in your blood have several different roles, such as helping regulate the amount of water in your body.
As glomerulonephritis can lead to a build-up of fluid, monitoring your intake of fluid and these minerals will help control the amount of fluid in your body.
Your diet will also need to be carefully controlled. Your GP or dietitian (a specialist in nutrition) will give you advice about eating protein and controlling your intake of potassium, salt and, sometimes, phosphate.
Phosphate is a mineral that, with calcium, makes up most of your bones. You get phosphate through your diet, mainly from dairy foods. Your kidneys usually filter out excess phosphate. If phosphate levels rise too much, it can upset the normal calcium balance of your body. This can lead to thinning of your bones and furring of your arteries.
Your blood will be regularly reviewed to ensure that it contains the right levels of potassium and sodium chloride, and that the amount of fluid in your diet is correct.
Medication
Glomerulonephritis is sometimes treated with medicines that suppress or control your immune system (the body’s natural defence against infection and illness). These types of medicines are known as immunosuppressant medicines.
It is thought that your immune system plays a part in causing glomerulonephritis (see Glomerulonephritis - causes). Therefore, suppressing your immune system can be an effective way to treat the condition. However, suppressing your immune system increases your risk of infections. Because of this, treatment with immunosuppressant medicines will be kept at the minimum level needed to treat your condition while lessening the risk of infections.
Other types of medicines may also be recommended to treat the underlying cause of glomerulonephritis, plus any other response that your body has to the condition.
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin-converting enzyme (ACE) inhibitors are a type of medicine that can be used to decrease the amount of protein in your urine. Reducing the amount of protein in your urine improves the outlook for the kidneys, regardless of the cause of the protein leak. ACE inhibitors are also widely used to treat high blood pressure in people with or without kidney disease.
Corticosteroids
Corticosteroids are medicines that contain steroids, a type of hormone. Hormones are powerful chemicals that have a wide range of effects on the body.
Corticosteroids are used to reduce inflammation (swelling) and suppress your immune system. Prednisolone is the most common corticosteroid that you might be prescribed.
See the Health A-Z topic about Corticosteroids for more information about this type of medication.
Cyclophosphamide
Cyclophosphamide is used in very high doses to treat some cancers, but it is also an established treatment, in much lower doses, for glomerulonephritis.
Other medicines
Other medicines to help control your immune system include:
- rituximab - an antibody medicine that attacks the white blood cells that can produce antibodies
- mycophenolate mofetil - an immunosuppressant
- ciclosporin - an immunosuppressant
- tacrolimus - an immunosuppressant
Maintenance therapy
Once your kidneys have started to recover, your dose of corticosteroid medicine will usually be lowered. You may continue to take other medicines, or you may change to something that is not as strong. For example, you may change to azathioprine.
Plasma exchange
Plasma is a clear, yellowish fluid that is part of the blood. It contains proteins, such as the antibodies that cause your kidneys to become inflamed. Plasma exchange is a procedure that removes some of the plasma from your blood.
During plasma exchange, you are connected to a machine that removes some of your blood. The plasma is separated from the blood cells and removed. The blood cells are then put back into your body. The removed fluid is replaced, either with regular fluids or with the plasma from healthy blood donors.
Plasma exchange may be used if your condition is particularly severe. Evidence suggests it may reduce the risk of end-stage kidney failure, where the kidneys have permanently failed.
See the Health A-Z topic about Plasma products - how they are used for more information about plasma exchange.
Treating high blood pressure
Glomerulonephritis can lead to high blood pressure (hypertension), which can cause further kidney damage and other health problems.
Your blood pressure will be carefully monitored by the healthcare professional who is treating you, and you may need to take medicines, such as ACE inhibitors. Often, people who have high blood pressure and kidney disease need to take several medicines to control their blood pressure.
See the Health A-Z topic about High blood pressure - treatment for more information.
Treating chronic kidney disease or kidney failure
In severe cases, if you have long-term kidney disease or your kidneys no longer work, you may need:
- kidney dialysis - where a machine is used to do the kidney’s job of removing waste products from your body
- a kidney transplant - where a healthy kidney from a donor is surgically implanted
Use the services directory to find kidney units in your area.
