Penn Medicine's Glomerular Diseases Clinic offers complete care for all types of glomerular disease. We are the only glomerular disease clinic in the region, and our clinical expertise for these rare diseases is among the best in the nation. Using a multidisciplinary approach, our physicians see extremely rare cases that are often difficult to treat, offering leading-edge care from experts who are the best in their field.
Glomerular disease refers to diseases of the filters of the kidney (glomeruli), which include two main categories:
- Inflammatory glomerular disease or glomerulonephritis
Lupus (SLE) and systemic vasculitis are multi-organ diseases that often involve the kidney and its filters.
Inflammation of glomeruli can also occur on its own without the presence of a systemic disease such as lupus and vasculitis; this is termed primary glomerular disease.
Common glomerular diseases that cause inflammation of the glomeruli include:
- Goodpasture's syndrome
- IgA nephropathy
- Non-inflammatory glomerular disease
There are other forms of glomerular disease that do not involve acute inflammation. These can be:
- primary in nature, involving the glomerulus alone.
- secondary in nature, associated with other systemic diseases.
- Signs and Symptoms of Glomerular Disease
Signs and symptoms associated with glomerular disease breakout into several clinical syndromes:
- Nephrotic syndrome:
- Proteinuria - excessive protein (>3g in 24hrs) in the urine causing "foamy urine"
- Edema - fluid retention in the legs, feet, hands, face, and abdomen
- High cholesterol
- Low blood albumin
- Inefficient filtration of waste from the blood
- Hypoproteinemia - low blood protein
- Hematuria - blood in the urine
- Nephritic syndrome:
- Microscopic hematuria - blood in urine that can only be seen by a microscope
- Rapidly Progressive Glomerulonephritis (RPGN) - nephritic syndrome plus a relatively rapid loss of kidney function.
- Simple excess proteinuria
- Nephrotic syndrome:
- Glomerular Disease Diagnosis
Penn's Glomerular Disease Clinic offers the latest advancements in diagnostic testing for glomerular diseases including:
- Urinalysis - to assess levels of protein and blood in the urine.
- Blood tests - to assess levels of waste in the blood and can indicate kidney damage. Blood tests are often used to help pinpoint the cause of glomerular disease.
- Ultrasound or advanced radiographic imaging may be performed to indicate kidney abnormalities (renal imaging).
- A kidney biopsy may be performed to confirm and help determine the cause of a glomerular disease.
- Genetic testing to identify genetic causes of glomerular disease.
- Glomerular Disease Treatment and Services
Penn physicians provide comprehensive, high quality patient care for all types of glomerular diseases. Our services include:
- Diagnosis, including renal biopsy and biopsy interpretation services.
- Careful integration of care with referring physicians.
- Individualized treatment plans.
- Specialized nursing care provided to ensure careful follow up and close communication with patients undergoing intensive therapies.
- Dietary counseling by knowledgeable nutritionists.
- Opportunities to participate in clinical trials of novel therapies or other relevant clinical studies.
Common treatments for glomerular disease include:
- Immunosuppressive medications.
- If caused by an infection, antibiotics may be prescribed.
- Treatment at the Infusion Center by highly skilled nurses specially trained to administer and monitor immunosuppressive drugs.
- Monitoring of diet and nutrition.
Penn's Glomerular Diseases Clinic implements a multidisciplinary approach to care working closely with:
- Penn Rheumatology, where rheumatologic diseases are the cause of glomerulonephritis.
- Penn High Risk Obstetrics for care of women with glomerular disease considering pregnancy or who are pregnant.
- Penn Oncology where glomerular disease is caused by malignancy including multiple myeloma.
- Penn Infectious Disease where glomerular disease is caused by chronic bacterial infection.
- Penn Liver GI where glomerular disease is caused by hepatitis C viral infection.