Glomerulonphropathy Print

**Glomerulonephropathy** in dogs refers to a group of diseases affecting the glomeruli, the filtration units of the kidneys. These diseases disrupt the kidneys' ability to filter waste and retain essential proteins, leading to progressive kidney damage. 

Key Features of Glomerulonephropathy:

1. **Causes**  
Glomerulonephropathy can be primary (directly affecting the glomeruli) or secondary (resulting from systemic diseases):  
- **Primary Causes**: 
  - Immune-mediated glomerulonephritis.  
  - Hereditary glomerulopathies (e.g., familial in breeds like Soft-Coated Wheaten Terriers).  
- **Secondary Causes**: 
  - Chronic infections (e.g., Lyme disease, heartworm).  
  - Immune-mediated diseases (e.g., lupus).  
  - Cancer.  
  - Other systemic conditions like diabetes or amyloidosis.

2. **Pathophysiology**  
- Damage to the glomeruli leads to leakage of proteins (especially albumin) into the urine (**proteinuria**).  
- Loss of albumin can cause low blood protein levels (**hypoalbuminemia**) and fluid buildup (**edema**).  
- Over time, chronic damage to the kidneys can progress to chronic kidney disease (CKD).  

3. **Clinical Signs**  
Signs vary depending on the stage of the disease:  
- Early stages:
  - Proteinuria (detected during routine urine tests).  
  - No obvious outward symptoms.  
- Advanced stages:
  - Weight loss and poor appetite.  
  - Lethargy.  
  - Swelling (edema) in the limbs or abdomen.  
  - Increased thirst and urination (if kidney function declines).  
  - Vomiting and signs of uremia in end-stage disease.  

4. **Diagnosis**  
- **Urinalysis**: Detects proteinuria and evaluates urine concentration.  
- **Blood tests**: Assess kidney function (BUN, creatinine) and albumin levels.  
- **Urine protein-to-creatinine ratio (UPC)**: Quantifies protein loss in urine.  
- **Blood pressure**: Hypertension is a common complication.  
- **Kidney biopsy**: Definitive diagnosis and classification, often used when hereditary disease or immune-mediated glomerulonephritis is suspected.  

5. **Treatment**  
Management depends on the underlying cause and disease progression:  
- **Proteinuria Management**: 
  - ACE inhibitors (e.g., enalapril, benazepril) or ARBs (e.g., telmisartan) to reduce protein loss.  
- **Diet**: Low-protein, low-sodium, kidney-supportive diets.  
- **Blood Pressure Control**: Antihypertensive medications if hypertension is present.  
- **Underlying Cause**: Treat infections, immune-mediated diseases, or cancer contributing to the condition.  
- **Edema/Ascites Management**: Diuretics (e.g., furosemide) if necessary.  
- **Supportive Care**: Phosphorus binders, omega-3 fatty acids, and other kidney-protective supplements.  

6. **Prognosis**  
- **Early Detection**: Slowing progression is possible with early intervention.  
- **Advanced Disease**: May progress to chronic kidney disease, which requires lifelong management.  

Breeds at Higher Risk  
Certain breeds, such as Bernese Mountain Dogs, Soft-Coated Wheaten Terriers, and English Cocker Spaniels, are predisposed to hereditary forms of glomerulonephropathy. Regular screening is recommended for these breeds.  

Glomerulonephropathy requires a tailored, multi-faceted approach to manage symptoms, address the underlying cause, and slow kidney damage.