Glomerulosclerosis

Glomerulosclerosis is a condition characterized by scarring or hardening (sclerosis) of the tiny filters in the kidneys known as glomeruli. Normally, these structures help filter waste and excess fluid from your blood. When the glomeruli become scarred, they can’t perform their job effectively, which can eventually lead to impaired kidney function or kidney failure.

What medical conditions are associated with glomerulosclerosis?

Glomerulosclerosis is commonly seen in medical conditions such as:

• Diabetes (diabetic nephropathy).
• High blood pressure (hypertensive nephropathy).
• Focal segmental glomerulosclerosis (FSGS).
• Chronic kidney disease.
• Obesity-related kidney disease.
• Certain autoimmune diseases.

What causes glomerulosclerosis?

Several factors can lead to glomerulosclerosis. Chronic high blood pressure and diabetes are the most common causes. Other factors include obesity, infections, autoimmune conditions, and genetic predispositions. Long-term exposure to these conditions damages the blood vessels and filtering units in the kidneys, causing the glomeruli to become scarred.

What are the symptoms of glomerulosclerosis?

Early in the disease, glomerulosclerosis may cause few or no noticeable symptoms. However, as kidney function declines, symptoms can develop, including:

• Swelling of the feet, ankles, or face.
• Fatigue.
• Increased urination, especially at night.
• Foamy or bubbly urine (due to protein leakage).
• High blood pressure.
• Loss of appetite.
• Weight gain due to fluid retention.

What does glomerulosclerosis look like under the microscope?

Under the microscope, glomerulosclerosis appears as scarring or thickening of the glomerular tissue. Pathologists see increased fibrous tissue within the glomeruli, which replaces normal functioning kidney tissue. In some cases, the sclerosis is focal (affecting only some glomeruli) and segmental (affecting parts of each glomerulus), as seen in focal segmental glomerulosclerosis (FSGS). In other instances, the sclerosis may affect many or all of the glomeruli, leading to widespread kidney damage.

Is glomerulosclerosis reversible?

Unfortunately, glomerulosclerosis is generally not reversible once significant scarring has occurred. However, if diagnosed early, treatments may slow or stop the progression of the disease and help preserve kidney function.

What is the difference between glomerulosclerosis and glomeruloscleritis?

Glomerulosclerosis specifically refers to the scarring and hardening of the glomeruli resulting from chronic damage. Glomeruloscleritis, however, implies inflammation (“-itis”) of the glomeruli accompanied by sclerosis. The presence of active inflammation distinguishes glomeruloscleritis from glomerulosclerosis, which typically involves chronic, non-inflammatory scarring.

What is the prognosis for someone with glomerulosclerosis?

The prognosis for someone with glomerulosclerosis depends on the underlying cause, how early it is diagnosed, and how well it responds to treatment. Early detection and management of underlying conditions like diabetes and hypertension are crucial. While significant scarring cannot be reversed, treatments aimed at controlling these conditions and protecting kidney function can greatly improve outcomes and slow disease progression.

Questions to ask your doctor

• What caused my glomerulosclerosis?
• How much kidney function have I lost?
• What treatments do you recommend?
• Can lifestyle changes help slow the progression?
• How often should my kidney function be monitored?
• Are there symptoms that I should watch for closely?
• Could I benefit from seeing a kidney specialist (nephrologist)?