Glomerulosclerosis

What is glomerulosclerosis?

Glomerulosclerosis is scarring of the tiny filtering units inside the kidneys called the glomeruli.

What causes glomerulosclerosis?

Glomerulosclerosis may develop in children or adults and may result from many different causes. Glomerulosclerosis may be caused by infection, certain medicines, diabetes, sickle cell disease, lupus, or another glomerular disease.

What are the symptoms of glomerulosclerosis?

Early stages of glomerulosclerosis may not cause any symptoms. The most important sign of this condition is protein in the urine (proteinuria). This is often found during a routine exam. The loss of large amounts of protein could cause swelling in the ankles. It can also cause a buildup of fluid in the abdomen, puffy eyes, or weight gain from widespread fluid buildup. Severe proteinuria could mean end-stage renal disease (ESRD) will develop.

How is glomerulosclerosis diagnosed?

Scarring causes problems with the filtering process of the kidneys. This causes protein to leak from the blood into the urine, where it can be detected. Blood and urine tests can often diagnose this condition.

Glomerulosclerosis is just one of many possible causes of protein in the urine. You may need a kidney biopsy to confirm the diagnosis. In a biopsy, a tiny sample of kidney tissue is looked at under a microscope.

What is the treatment for glomerulosclerosis?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Scarred glomeruli can't be repaired. Treatment aims to prevent further damage and to avoid dialysis. The best treatment for glomerulosclerosis depends on what caused the scarring. The cause is determined by a kidney biopsy. Treatment may include:

• Immune system medicines. Medicines are used to block the body's immune system. This prevents the body from making antibodies that may attack the glomeruli.

• Dialysis. This treatment removes waste products and excess fluid from the blood after the kidneys have stopped working.

• Kidney transplant. This procedure replaces your diseased kidney with a healthy one from a donor.

• Blood pressure lowering medicines.

• Diet changes. You may need to limit salt and protein in your diet.

What are possible complications of glomerulosclerosis?

Even with treatment, complications may develop. Your kidney function may decline to the point of kidney failure. This can require treatment such as dialysis or even a kidney transplant.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know right away.

Key points about glomerulosclerosis

• Glomerulosclerosis is scarring of the tiny filtering units inside the kidneys (glomeruli). This causes a loss of protein into the urine. These proteins help fluid stay within the blood vessels. Without them, fluid leaks into the nearby tissue and causes swelling.

• Fluids are not properly filtered from the body by the kidneys into the urine. This causes fluid to build up in the body.

• Medicines to decrease the inflammation and swelling can be used.

• For severe scarring, dialysis or a kidney transplant may be needed for long-term survival.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.