Treatment of Glomerular Diseases in Thailand

The kidneys body organs that are bean-shaped and approximately fist-sized. They are located just below the rib cage on each side of the body. Kidneys normally work by filtering toxins out of the bloodstream and excreting them in the urine while keeping proteins and red blood cells in the bloodstream. They use nephrons which are tiny structures to filter the body's blood supply. Each nephron is composed of a glomerulus which filters waste and excess fluids and a tubule, which modifies the waste to form urine. When someone suffers glomerular disease toxins may be retained in the bloodstream; while red blood cells and protein may be excreted in the urine.

This disease can develop by itself by affecting only the kidneys. It can also be connected with underlying medical conditions such as diabetes, lupus or certain infections which affect other organ systems.

There are two basic types of glomerular disease include nephritic and nephrotic. However, the two types can sometimes overlap.
• Nephritic: The most common symptom of nephritic disease is hematuria; blood in the urine. In mild cases of the disease, a person with glomerulonephritis may be asymptomatic without any significant impairment of kidney function or proteinuria.
• Nephrotic: The most common symptom of nephritic symptom is proteinuria; protein in the urine. As nephrotic syndrome progresses kidney function may worsen.

• You should see a doctor if you experience any of the following symptoms.
• Discolored urine
• Excessive protein in the urine
• Elevated blood pressure
• Edema in the abdomen, hands, face or feet
• Fatigue
• Frequent Urination

If you experience symptoms of glomerular disease, there are several tests that your doctor will order to diagnose glomerular disease.

• Urine tests: Urinalysis may show red blood cells, white blood cells or increased protein levels if there is damage or inflammation in the glomeruli.
• Blood tests: These are used to measure the level of creatinine and blood urea nitrogen, which become elevated when the kidneys are damaged and are not filtering properly.
• Imaging tests: An ultrasound of the kidney is the most frequently recommended imaging test ordered when glomerular disease is suspected. It is mainly done to rule out other causes of decreased kidney function or blood in the urine.
• Kidney biopsy: may be required to confirm the cause of glomerular disease in patients who cannot be diagnosed by blood tests or imaging tests alone.

Treatment

The onset of glomerular disease can be sudden (called acute), or the disease can be chronic developing slowly over a period of years. Treatment of glomerular disease depends on its cause and type. Depending on this, improvement may be seen as the infection is treated. However, sometimes management is the only option. This is important to prevent further damage to the kidneys