Glomerulosclerosis is a disease pertaining to kidneys. It is characterized by sclerosis (scarring) of glomeruli. Glomeruli are microscopic capillaries situated in kidneys. Their function is to filter the waste from the blood passing through kidney. The waste is then discharged out of the body in the form of urine. When the glomeruli are scarred they do not function properly. As a result protein is passed out along with waste from urine. Increased passage of protein in urine is called proteinuria.
Glomerulosclerosis is a serious condition that can progress to end stage renal failure.It can occur both in children as well as adults. Glomerulosclerosis is caused due to uncontrolled diabetes and diseases such as lupus. It can also occur as a result of focal segmental glomerulosclerosis (FSGS).
Symptoms of glomerulosclerosis include swelling in feet, hands, abdomen, foamy urine, and proteinuria in urine test. There is no cure for glomerulosclerosis. Treatment consists of slowing the progression of disease and controlling symptoms.
What Are The Causes Of Glomerulosclerosis?
Glomerulosclerosis is scarring of glomeruli in kidney. Several causes have been found to cause glomerulosclerosis. One of the important causes is diabetes.Uncontrolled diabetes for long duration can gradually damage the glomeruli and its filtration rate. Patients suffering from lupus are also vulnerable to develop glomerulosclerosis. Lupus is autoimmune disease encompassing various organs which also includes kidney. Glomerulosclerosis and kidney damage also occurs due to hypertension.
A condition called focal segmental glomerulosclerosis (FSGS) is form of glomerulosclerosis where only certain segments of glomeruli are damaged or scarred. The other glomeruli are healthy. Etiopathogenesis of FSGS is incompletely understood. In primary FSGS the cause remains unclear. In some patients the disease is secondary to certain infections, drug toxicity, and obesity. The rare form of focal segmental glomerulosclerosis is caused due to genetic mutation. The defective gene is passed on from parents to the child. There may be a history of FSGS in family members.
Signs And Symptoms Of Glomerulosclerosis
Every human being has 2 kidneys. The function of kidney is to filter blood and produce urine to remove the waste products and excess of fluids from the body. Each kidney consists of tiny filtering apparatus in the form of capillaries called glomeruli.
When the glumeruli are damaged, kidneys cannot filter out waste and fluid properly from the body. At the same time protein is not retained in the body and it is passed out. This leads to development of symptoms and gradual kidney failure. However in glomerulosclerosis the symptoms are not instantaneous. They develop over a period of time. The most common symptoms are:
- Swelling in feet and ankle.
- Swelling in abdomen and face.
- Low protein in blood (hypoproteinemia).
- Foamy urine
- High blood pressure
- High cholesterol
Swelling occurs due to retention of fluid and hypoproteinemia. Proteinuria is protein present in urine during urine analysis. This test is important to know to the extent of glomeruli damage.
Treatment Guidelines For Glomerulosclerosis
Although urine analysis test shows proteinuria, the confirmatory test for diagnosis of glomerulosclerosis is kidney biopsy. During biopsy small tissue particles from the kidney are removed. When seen under microscope, the tissue may show scarred glomeruli. Besides kidney biopsy other tests include glomerular filtration rate measurement, ultrasound of kidney and genetic testing.
Glomerulosclerosis is incurable disease. Once the glomeruli are damaged they cannot reverse back to normal. However, detecting the disease is its early stage will help to reduce progression of scarring. The main aim is to stop progression of scarring and control symptoms.
Following is treatment mode for glomerulosclerosis:
- The first line of treatment is use of steroids to reduce inflammation and control loss of protein.
- Medicines that are used for blood pressure called ACE inhibitors are beneficial to reduce loss of protein from kidney and reduce blood pressure as well.
- Use of statins is beneficial to reduce cholesterol.
- Swelling in different parts of body is reduced with the help of diuretics and low salt diet.
- Anti coagulant medicines to prevent blood clots.
- Eating healthy foods to maintain proper protein and fluids in the body.
- Quitting smoking
- Regular exercising
- Controlling blood sugar in diabetics and treating underlying infection if it is the cause for glomerulosclerosis.
Eventual outcome of glomerulosclerosis is gradual deterioration of kidney function leading to end stage kidney disease.