Glomerulonephritis - Treating glomerulonephritis

Treatment for glomerulonephritis depends on the cause of your condition and the symptoms you have.

In mild cases, treatment isn't always necessary. If treatment is needed, it will usually be carried out by a kidney specialist (a nephrologist or renal medicine consultant).

Treatment for glomerulonephritis is usually effective, although complications of glomerulonephritis can sometimes develop.

Dietary changes

Your GP or dietitian will give you relevant advice about diet. You may be advised to reduce your intake of:

• food containing a high amount of salt
• food or drinks containing a high amount of potassium
• fluid

This should help control your blood pressure and ensure the amount of fluid in your body is regulated.

You should be regularly reviewed to ensure your blood contains the right levels of potassium, sodium chloride and other salts.

Stopping smoking

Smoking may make kidney disease caused by glomerulonephritis worse more quickly. It also increases the risk of complications such as heart disease and stroke, which are already more common in people with glomerulonephritis.

If you have glomerulonephritis and you smoke, stopping smoking has important health benefits.

Immunosuppressants

Severe cases of glomerulonephritis, caused by problems with the immune system, are sometimes treated with types of medicine known as immunosuppressants. These medicines suppress your immune system.

Suppressing your immune system can be an effective way of treating glomerulonephritis, but it also increases your risk of infections and can cause other side effects.

If you are offered treatment with immunosuppressant medicines, they will be adjusted to the level needed to treat your condition and will be carefully monitored.

Corticosteroids

Corticosteroids are medicines containing steroids, which are 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 a common corticosteroid you might be prescribed.

Once your kidneys have started to recover, your dose of corticosteroid medicine will usually be lowered. You may continue to take a small dose, or this treatment may be stopped altogether.

Cyclophosphamide

Cyclophosphamide is used in very high doses to treat some cancers, but it's also an established treatment, in much lower doses, for glomerulonephritis.

Other immunosuppressants

Other medicines to help control your immune system include:

• mycophenolate mofetil
• azathioprine
• rituximab
• ciclosporin
• tacrolimus

Other medicines

If your condition is thought to be linked to a viral infection, it may be treated with antiviral medication.

Individual symptoms can sometimes be treated. For example, swelling caused by a build-up of fluid may be treated with a type of medication called a diuretic.

Treating high blood pressure

Glomerulonephritis often leads to high blood pressure, which can cause further kidney damage and other health problems.

Your blood pressure will be carefully monitored by the healthcare professionals treating you. You may need to take medicines, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB), which lower blood pressure and help reduce the amount of protein that leaks into your urine.

Often, people who have high blood pressure and kidney disease need to take several medicines to control their blood pressure.

These medications are commonly prescribed, even if your blood pressure is not particularly high, as they can help to protect the kidneys.

Read more about treating high blood pressure.

Treating high cholesterol

High cholesterol levels are common in people with glomerulonephritis.

Your doctor may recommend treatment with medication to reduce cholesterol and help protect you against complications such as heart and vascular disease. Statins are the most frequently used medication.

Read more about treating high cholesterol.

Plasma exchange

Plasma is a fluid that is part of the blood. It contains proteins, such as antibodies that can cause your kidneys to become inflamed. Plasma exchange involves removing some of the plasma from your blood.

During the procedure, you are connected to a machine that gradually removes some of your blood. The plasma is separated from the blood cells and removed. A plasma substitute is then added to the blood before it's put back into your body.

Plasma exchange may be used in certain circumstances if your condition is particularly severe (usually if you have a type of glomerulonephritis called ANCA vasculitis or anti-glomerular basement membrane disease).

Read more about how plasma products are used.

Treating chronic kidney disease or kidney failure

In severe cases that cannot be improved with other treatments, you may require:

• kidney dialysis – a treatment that takes over part of the kidney’s job and removes waste products from your body 
• a kidney transplant – where a healthy kidney from a donor is surgically implanted to replace your own kidney

Use the services directory to find kidney units in your area.

Vaccinations

People with glomerulonephritis can be more prone to infections, particularly if:

• you have nephrotic syndrome (see symptoms of glomerulonephritis for more information)
• you develop chronic kidney disease

It's usually a good idea to help protect yourself against infection by having a seasonal flu jab and a pneumonia jab.