🔬 Men's Health
Glomerulonephritis in Nigeria
Kidney inflammation — causes and treatment in Nigeria
Glomerulonephritis (GN) is inflammation of the glomeruli — the tiny filtering units of the kidney. It is an important cause of kidney disease in Nigeria, particularly in children and young adults, and differs from the hypertension-and-diabetes-driven CKD that predominates in older Nigerians. Important causes in the Nigerian context include post-streptococcal GN (following strep throat or skin infection), IgA nephropathy, lupus nephritis, hepatitis B and C-related GN, and malaria-associated nephropathy.
Signs and Symptoms
✓ Nephritic syndrome (inflammatory pattern): blood in the urine (haematuria — dark/cola-coloured urine), reduced urine output, facial puffiness especially in the morning, high blood pressure — classic presentation of post-streptococcal GN in children
✓ Nephrotic syndrome (leaking pattern): severe leg and facial swelling (oedema), frothy urine (heavy protein loss), low blood albumin, high cholesterol
✓ Asymptomatic: blood or protein found on urine dipstick during a routine check
✓ Rapidly progressive GN: rapid kidney function decline over days to weeks — emergency
When to Seek Help
Urgent — same weekAny child with dark (cola-coloured) urine and swollen face — post-streptococcal GN; referral to paediatrician or nephrologist for blood pressure monitoring and treatment
EmergencySevere hypertension, seizures, or rapidly worsening kidney function in a child or adult with nephritis — hypertensive emergency requiring immediate treatment
Investigate unexplained swellingGeneralised oedema (swelling of face, legs, and body) without obvious cardiac or liver cause — nephrotic syndrome to be excluded with urine protein:creatinine ratio
Tests & Diagnosis
🧪 Urine dipstick and microscopy
Haematuria and proteinuria — the hallmarks of GN; red cell casts on microscopy are specific for glomerulonephritis
🧪 Urine protein:creatinine ratio
Quantifies proteinuria; >300mg/mmol = nephrotic range
🧪 ASO titre and complement (C3, C4)
Low C3 with raised ASO titre confirms post-streptococcal GN
🧪 ANA, dsDNA antibodies
Positive in lupus nephritis
🧪 Kidney biopsy
Definitive diagnosis — identifies the type of GN and guides immunosuppressive treatment; essential for nephrotic syndrome in adults and selected children
🧪 Hepatitis B, C, and HIV serology
All patients with GN should be screened for these infections
Frequently Asked Questions
Is dark (cola-coloured) urine always from kidney disease?
Not always — dark urine can be from dehydration, haemolysis (malaria), liver disease, muscle breakdown (rhabdomyolysis), or certain medications (metronidazole, rifampicin). However, dark urine with facial swelling and high blood pressure strongly suggests post-streptococcal glomerulonephritis and needs same-week investigation.
Can children outgrow glomerulonephritis?
Post-streptococcal GN typically resolves completely in children. Minimal change nephrotic syndrome has a good long-term prognosis with appropriate steroid treatment, though relapses are common. Some forms (IgA nephropathy, lupus nephritis) can be chronic and progressive.
Does malaria cause kidney problems?
Yes — Plasmodium malariae causes quartan malarial nephropathy, a form of glomerulonephritis common in Nigerian children presenting with nephrotic syndrome. It is managed differently from other forms and is an important diagnosis not to miss in endemic areas.
Is kidney biopsy safe?
Kidney biopsy carries a small risk of bleeding (<1% requiring transfusion or intervention) and is performed under ultrasound guidance with the patient prone. It is an essential investigation for diagnosing glomerulonephritis type and guiding treatment. It should be performed by a trained nephrologist or interventional doctor.
Can lupus nephritis be treated in Nigeria?
Yes — hydroxychloroquine and mycophenolate mofetil for lupus nephritis are available at teaching hospitals and some private rheumatology/nephrology centres. Treatment is lifelong and requires regular monitoring. The Lagos Lupus Support Group provides peer support and connects patients with specialist care.