Glomerulonephritis in Children

What is glomerulonephritis?

Glomerulonephritis is a type of kidney disease. It involves tiny structures in the kidneys called the glomeruli. With this condition, these small structures become inflamed. This makes it hard for the kidneys to filter urine.

What causes glomerulonephritis?

Glomerulonephritis is caused by several different disease states, including the following:

  • Systemic autoimmune diseases. With these types of diseases, the body’s immune system attacks healthy cells by mistake. Systemic means that many parts of the body are affected. An example of this is systemic lupus erythematosus (SLE or lupus).

  • Other systemic diseases. These may include:

    • Polyarteritis nodosa group. An inflammatory disease of the arteries.

    • Wegener vasculitis. A progressive disease that leads to widespread inflammation of all of the body's organs.

    • Henoch-Schönlein purpura. A disease usually seen in children. It is linked to small or large purple lesions (purpura) on the skin and internal organs, and involves several organ systems.

  • Alport syndrome. This is a form of inherited glomerulonephritis that affects both men and women. But men are more likely to have kidney problems. Treatment focuses on preventing and treating high blood pressure and preventing kidney damage.

  • Streptococcal infection. In children, glomerulonephritis is often caused by strep throat or an upper respiratory infection. The disease usually occurs more than 1 week after an infection.

What are the symptoms of glomerulonephritis?

The following are the most common symptoms of glomerulonephritis:

  • Dark brown-colored urine (from blood and protein)

  • Sore throat

  • Decreased urine output

  • Lack of energy or tiring easily (fatigue)

  • Lethargy

  • Increased breathing effort

  • Headache

  • High blood pressure

  • Seizures (may occur as a result of high blood pressure)

  • Rash, especially over the buttocks and legs

  • Weight loss

  • Joint pain

  • Pale skin color

  • Fluid buildup in the tissues (edema)

The symptoms of glomerulonephritis may look like other conditions and medical problems. Always see your child's healthcare provider for a diagnosis.

How is glomerulonephritis diagnosed?

Your child’s healthcare provider will do a physical exam and take your child’s health history. The provider may recommend testing such as a throat culture and urine and blood tests. Other tests may include:

  • Electrocardiogram (ECG or EKG). A test that records the electrical activity of the heart, shows abnormal heart rhythms, and detects heart muscle damage.

  • Kidney ultrasound. A noninvasive test in which a transducer is passed over the kidney producing sound waves which bounce off of the kidney, transmitting a picture of the organ on a video screen. The test is used to determine the size and shape of the kidney and to detect a mass, kidney stone, cyst, or other obstruction or abnormalities. 

  • Chest X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.

  • Kidney biopsy. A small sample of tissue is taken from the kidney and sent to a lab for special testing to determine the specific disease. 

What is the treatment for glomerulonephritis?

Your child's healthcare provider will figure out the best treatment plan for your child based on:

  • Your child’s age, overall health, and medical history

  • How sick your child is

  • How well your child handles certain medicines, treatments, or therapies

  • If your child’s condition is expected to get worse

  • The opinion of the healthcare providers involved in your child's care

  • Your opinion and preference

Treatment will depend on the underlying cause. Treatments focus on slowing the progression of the disease and preventing complications.

  • Treatment may include:

  • Fluid restriction

  • Reduced protein diet

  • Reduced salt and potassium diet

  • Medicine, such as:

    • Medicines to increase urination (diuretics)

    • Blood pressure medicines

    • Medicines to decrease the amount of the mineral phosphorus in the blood (phosphate binders)

    • Medicines to reduce the strength of the body’s immune system (immunosuppressives)

  • Dialysis, a medical treatment to remove wastes and additional fluid from the blood after the kidneys have stopped working. Dialysis may be required for short-term or long-term therapy.

If glomerulonephritis does not resolve, long-term kidney failure may need to be addressed.

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