American Medical Association Family Medical Guide - American Medical Association [534]
Symptoms
Mild, chronic glomerulonephritis produces no symptoms. In many cases, a doctor detects the condition with blood or urine tests performed for another purpose. In some cases, small amounts of blood in the urine may cause it to look smoky; larger amounts of blood make the urine look bright red.
In severe, acute glomerulonephritis, you may feel generally ill, with drowsiness, nausea, and vomiting—all symptoms of impending kidney failure. You will probably be producing very small amounts of urine. You may urinate less frequently during the day and wake up at night to urinate. Fluid may accumulate in your body tissues, causing a condition called edema, which makes your skin, particularly around the ankles, look puffy. You may notice swelling around your eyes in the morning. If fluid accumulates in your chest, you may become short of breath.
Diagnosis
If you have symptoms of glomerulonephritis, your doctor will order a urine test to check for protein and red blood cells. If the test results indicate that you could have glomerulonephritis, the doctor will probably order additional tests, such as blood tests, an ultrasound (see page 111) or a CT scan (see page 112), or a kidney biopsy, in which a small sample of kidney cells is removed through a hollow needle and examined under a microscope.
Treatment
Many forms of glomerulonephritis require no treatment other than rest. Other forms of the disease can be treated with corticosteroids or immune-suppressing drugs to relieve inflammation or dampen the errant immune response. If an underlying condition is causing the problem, you will receive treatment for the condition.
If you have edema, your doctor may prescribe diuretics to reduce the amount of fluid your body retains. To treat high blood pressure, your doctor may prescribe antihypertensive medication to help control your blood pressure. If you have developed iron deficiency anemia (see page 610) as a result of the disorder, your doctor may prescribe iron and vitamin supplements. If glomerulonephritis leads to end-stage kidney failure, a doctor will treat the kidney failure.
Cystitis
Cystitis is inflammation of the bladder, usually caused by a urinary tract infection. The bladder functions as a temporary storage site for urine, and expels urine from the body through a muscular tube called the urethra. Cystitis occurs more frequently in women than in men because a woman’s urethra is shorter, providing bacteria and other germs from outside the body easier access to the bladder. Cystitis in men usually results from an inflamed or enlarged prostate gland or another abnormality of the lower urinary tract.
Symptoms
The main symptom of cystitis is a frequent urge to urinate that produces only a small amount of urine, which is sometimes strong-smelling or bloody. Because the urethra often also becomes inflamed in cystitis, you are likely to experience a burning or stinging sensation when you urinate. You may wake up during the night with a strong urge to urinate, and you may have a feeling of discomfort below your navel, where your bladder is. Cystitis can also cause a fever.
Diagnosis
If you have symptoms of cystitis, your doctor may order a urine test to check for bacteria and white blood cells, which are signs of infection. The urine sample is grown in a laboratory to confirm the presence of an infection, identify the microorganism that is causing the infection, and determine the best treatment.
Treatment
To help relieve your symptoms, your doctor will recommend drinking large quantities of water (at least eight large glasses every day). If there are bacteria in your urine, your doctor will prescribe antibiotics. The medication should clear up the infection within a few days, but you should continue taking the drugs until your doctor