Glomerular Disease Care

It's a group of conditions affecting the glomeruli — the kidney's tiny filters. When they're damaged, the kidneys can leak blood and protein into the urine and filter less well over time. Glomerulonephritis (inflammation of the filters) is one part of this group. Because there are many types, each treated differently, getting the diagnosis right matters.

Common signs include foamy urine (from protein), blood in the urine (sometimes tea- or cola-colored), swelling in the legs, ankles, or around the eyes, high blood pressure, and tiredness. Some glomerular disease is found only on a routine urine or blood test, before any symptoms appear.

Often, yes — a biopsy is the most reliable way to identify the exact type of glomerular disease, and the type determines treatment. It's a needle procedure that takes a tiny sample of kidney tissue to examine under a microscope. Your nephrologist will explain whether it's needed in your case and what to expect.

Treatment depends on the specific type. It may include medications that calm an overactive immune system, blood-pressure control, and steps to reduce protein in the urine and protect kidney function — often with ACE inhibitors or ARBs, and SGLT2 inhibitors where appropriate. For some conditions, newer targeted therapies are now available.

IgA nephropathy is in the middle of a treatment revolution. Recent years have brought the first medications developed specifically for it — including targeted-release budesonide, a selective endothelin-receptor antagonist, complement-pathway inhibitors, and an APRIL inhibitor — alongside long-standing blood-pressure and proteinuria control. Your nephrologist can say which, if any, fit your situation.

It depends on the type. Some forms resolve with treatment; others are long-term conditions managed to protect kidney function and slow progression. Identifying the exact disease early gives the best chance of preserving your kidneys, which is why careful diagnosis comes first.

A kidney biopsy is usually done with local numbing medicine and imaging guidance, and most people feel pressure more than pain. As with any procedure there are some risks, mainly bleeding, so it's done carefully and you're monitored afterward. Your nephrologist will walk through the benefits and risks for your situation before deciding.

Some patients may have the option to take part in clinical studies of newer therapies. Whether any fit depends on your specific diagnosis and health. Your doctor can discuss the options, and you can learn more on our clinical research page.

Reasonable reasons include protein or blood in the urine, unexplained swelling, a sharp or unexplained drop in kidney function, or a glomerular condition already suspected by another doctor. Earlier specialty care generally leads to better outcomes, because some glomerular diseases can progress quickly.