Glomerulonephritis: Treatment, Prognosis, and Lifestyle Impact - Internal Medicine

More Info

---

Glomerulonephritis is a complex condition characterized by inflammation of the glomeruli, the tiny filtering units within the kidneys. The treatment and prognosis of glomerulonephritis can vary significantly based on the underlying cause, the severity of the disease, and the patient's overall health.

Treatment Options
The primary treatment for glomerulonephritis often includes corticosteroids to reduce inflammation and suppress the immune response. In your case, it appears that you have been on a regimen of steroids, which has been effective in controlling proteinuria (the presence of excess protein in urine) and edema (swelling due to fluid retention). However, the need to increase your steroid dosage when tapering off indicates that your condition may require ongoing management.

In addition to corticosteroids, other immunosuppressive agents may be utilized, especially if the condition is severe or resistant to steroids. These can include medications like mycophenolate mofetil (Myfortic), which you mentioned, and other immunosuppressants. The goal is to achieve remission, defined as a reduction in proteinuria to less than 1 gram per day, and to maintain kidney function.


Prognosis
The prognosis for glomerulonephritis varies widely. Some patients may experience complete remission, while others may have persistent proteinuria or progressive kidney disease. The fact that your kidney function is currently at 90% is a positive sign, indicating that significant damage has not yet occurred. However, ongoing monitoring is crucial, as glomerulonephritis can lead to chronic kidney disease (CKD) if not adequately managed.

In general, about 40% of patients with glomerulonephritis may achieve complete remission, while 30-50% may have partial remission. Only about 10% may progress to end-stage renal disease (ESRD), which would necessitate dialysis or kidney transplantation. Regular follow-ups with your nephrologist are essential to monitor your condition and adjust treatment as needed.


Lifestyle Considerations
Your lifestyle, including working night shifts, can impact your overall health and potentially your kidney function. While there is no direct evidence linking night shifts to glomerulonephritis, chronic sleep deprivation and irregular sleep patterns can affect immune function and overall health. It is crucial to maintain a balanced diet, stay hydrated, and manage stress levels, as these factors can influence kidney health.

You mentioned that your doctor suggested that your kidney size is smaller than average. This could be congenital (present from birth) or acquired due to previous kidney damage or other factors. If there is a concern about the underlying cause of your glomerulonephritis, consulting with a specialist in immunology or nephrology may provide further insights.


Emotional and Psychological Impact
It is understandable to feel anxious about the possibility of needing lifelong medication or the fear of kidney deterioration. Chronic illnesses can take a toll on mental health, and it is essential to address these feelings. Engaging in stress-reducing activities, seeking support from friends or support groups, and discussing your concerns with your healthcare provider can be beneficial.


Conclusion
In summary, glomerulonephritis requires careful management and monitoring. While the need for long-term medication may be necessary for some patients, many can achieve remission with appropriate treatment. Regular follow-ups, lifestyle adjustments, and addressing any underlying conditions are vital components of managing your health. Always communicate openly with your healthcare provider about your concerns and treatment options to ensure the best possible outcomes.