Glomerulonephritis treatment

Many children with glomerulonephritis do not need any treatment but will be monitored by a paediatrician, a specialist children’s doctor. If your child’s glomerulonephritis is more severe and requires treatment, they may also be seen by a paediatric nephrologist, a children’s doctor specialising in kidneys.

Most children with glomerulonephritis are seen as outpatients. This means that they visit the hospital during the day and can go home again at night.

If your child’s glomerulonephritis is severe or they have any complications, they may need to stay in hospital for treatment.

This is usually needed if:

• your child has severe oedema, especially if there is a lot of fluid around their lungs that makes them breathless
• your child has very high blood pressure (hypertension)
• your child’s kidneys have stopped working properly, for example with rapidly progressive glomerulonephritis (RPGN)
• your child needs to take medicines but is not able to take them.

Your child’s healthcare team will:

• check your child’s kidney function (how well their kidneys are working)
• measure how much your child is drinking and how much urine they are passing
• test your child’s urine with a dipstick
• check your child’s blood pressure
• weigh your child to help find out if they have too much or too little fluid in their body.

Dietary changes may be recommended, including following a low-salt diet. This should only be undertaken with advice and monitoring by a specialist kidney dietitian.

Your child may be prescribed medication to control their blood pressure, reduce swelling in their body or treat infections.

It is important that you follow your doctor’s instructions about when and how much medicine to give to your child. Keep giving the medicine to your child as your doctor has told you, even if they are getting better.

Your child should have the flu vaccine each year.

Contact your doctor straight away if your child:

• has been in contact with someone who has chicken pox (if they have not had this illness before) or measles (if they have not had the MMR vaccine, which protects against measles, mumps and rubella)
• is unwell and you are worried about an infection

Follow up

Children who have been treated for glomerulonephritis will have follow-up appointments throughout their childhood. It is important to go to these appointments even if your child seems well. You will also have the opportunity to ask any questions. At these appointments, your child may have:

• their height and weight checked
• a physical examination
• urine tests – to check for blood, protein and other substances in their urine
• blood tests – to check for the amount of protein and other substances in their blood, and measure their kidney function
• their blood pressure measured.

Long-term effects

Mild disease

For many children with glomerulonephritis, the disease is quite mild and they will get better after treatment. When the disease goes away, this is called remission. These children will usually have no more kidney problems in childhood.

Further care

If your child needs more treatment, or if their glomerulonephritis keeps coming back, your doctor will monitor them over a long period of time. If the glomerulonephritis is caused by another condition, this will need to be treated.

Acute kidney injury

Children with glomerulonephritis are at risk of acute kidney injury (AKI) – when the kidneys suddenly stop working, either partly or completely. Some children need to take medicines or have more intensive treatment. Some children with AKI get better after a few weeks but others may be left with long term effects on their kidneys.

Long-term problems

A few children develop long-term problems with their kidneys. Their kidneys stop working as well as they should – this can also happen slowly, often over many years. This is called chronic kidney disease (CKD). Your child will need to go back to the hospital or clinic for regular follow-up appointments.

If this happens to your child, you will learn more over time about how to help manage the condition, and what to expect.

Impact on your child and your family

Children who have been successfully treated for glomerulonephritis can usually do the things that other children their age do. They should be able to continue going to school or nursery. They can play with other children and stay active.

Living healthily

Your child can help protect their kidneys by leading a healthy lifestyle through their child and adult years. This includes:

• eating a healthy diet – with at least five servings of fruit and vegetables a day, taking care not to eat too much salt, sugar and fats (especially saturated fats)
• getting plenty of exercise
• not smoking.

If you have any concerns or need additional support, speak with your doctor or nurse.

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