What is Rapidly Progressive Glomerulonephritis?

Rapidly progressive glomerulonephritis (RPGN) is a condition that adversely affects kidney function and can quickly become life-threatening. Also known as crescentic glomerulonephritis, RPGN is frequently associated with existing kidney disease and inflammatory conditions, such as vasculitis. Treatment is entirely dependent on the underlying cause of inflammation. In most cases, medication may manage symptoms and slow the progression of kidney failure. Acute cases may necessitate dialysis and kidney transplantation.

A diagnosis of rapidly progressive glomerulonephritis is generally made with the aid of laboratory testing. Blood panels and urinalysis are usually administered to assess kidney function and check for inflammation and infection. Signs indicative of glomerulonephritis often include crescent-shaped glomeruli, elevated creatinine levels and the presence of RPGN-associated antibodies. Additionally, protein will be insufficient in the blood, but excessively high in the urine. A needle biopsy of the kidney may also be performed to determine the prevalence of scarring or other physiological abnormalities.

The kidneys house a blood filtration system comprised of numerous capillaries called glomeruli. It is the responsibility of these capillaries to filter impurities from the blood. Once separated, the toxins are processed and eliminated as urine. In the presence of glomerulonephritis, the capillaries are inflamed, allowing impurities to slip by and remain in the blood. The accumulation of contaminants depletes the bloodstream of essential nutrients.

Individuals with existing kidney and inflammatory disease are at greatest risk for developing rapidly progressive glomerulonephritis. In some cases, severe or chronic bacterial infection may also damage the glomeruli, contributing to inflammation and the onset of RPGN symptoms. Chronic conditions that cause tissue scarring, such as diabetic-based kidney disease, will often compromise kidney function leading to the development of RPGN. It is not uncommon for some cases to be diagnosed as idiopathic, meaning there is no definite cause for its onset.

Signs of acutely impaired kidney function will often present with pronounced fluid retention and swelling in the lower extremities, namely the ankles and feet. Individuals with rapidly progressive glomerulonephritis will notice they urinate less often, but when they do the protein-laden urine may be frothy. It is not uncommon for some people to expel blood-tinged or dark, abnormally colored urine. Impaired glomeruli function often allows the passage of red blood cells into the urine, a condition known as hematuria, which makes the urine appear dark. As one's condition worsens, anemia can develop, causing one to become easily fatigued or feel weak with little physical activity.

Treatment for rapidly progressive glomerulonephritis is centered on alleviating the underlying cause for inflammation and slowing disease progression. Immunosuppressive and steroidal-based medications are generally administered to reduce inflammation and alleviate symptoms. If glomeruli impairment originates with an infection, antibiotics may be administered. Dialysis and plasmapheresis may be utilized to systematically remove toxins and RPGN-based antibodies from one’s system, further reducing inflammation and easing stress on the kidneys. Individuals with rapidly progressive glomerulonephritis-related end-stage or complete kidney failure may undergo transplantation.