Glomerulonephritis Treatment in Turkey

• Clinical assessment:
  • Medical and Nephrological Evaluation: A detailed history and physical examination assess swelling, urine changes, blood pressure, recent infections, autoimmune symptoms, medication exposure and family history of kidney disease. The physician also evaluates symptoms suggesting involvement of other organs, such as the skin, joints, lungs, or nervous system.
  • Urine and Kidney Function Assessment: Urinalysis can detect blood, protein and other abnormalities. Urine albumin-to-creatinine or protein-to-creatinine ratios quantify protein loss, while blood tests, including serum creatinine and estimated glomerular filtration rate (eGFR), assess kidney function.
  • Blood and Immunological Assessment: Blood tests may include complete blood count, electrolytes, albumin, inflammatory markers and tests for the suspected underlying cause.
  • Kidney Biopsy: A kidney biopsy may be recommended when the diagnosis is uncertain, when an immune-mediated disease is suspected or when determining the specific type and severity of glomerular injury will influence treatment.
  • Assessment for Systemic Disease: Additional evaluation may identify autoimmune, infectious, genetic, or other systemic conditions associated with glomerulonephritis.
• Imaging Tests:
  • Renal Ultrasound: Helps assess kidney size, structure and possible urinary tract abnormalities.
  • Doppler Ultrasound: May be used when renal blood flow or vascular abnormalities are clinically suspected.
  • CT Scan: May provide additional anatomical information when ultrasound findings are insufficient, or another abdominal or systemic condition is suspected.
  • MRI: May be used selectively when detailed soft-tissue or vascular assessment is required.
  • Chest Imaging: Chest X-ray or CT may be performed when lung involvement is suspected, particularly in systemic autoimmune diseases such as ANCA-associated vasculitis or anti-GBM disease.

MediRehab (a chain of Rehab centres, part of MediGence) provides comprehensive tele-rehabilitation services designed to support Neuromyelitis Optica patients in Turkey. These services include:

• Physical Activity and Exercise
  Individualised physical activity can help maintain strength, mobility and cardiovascular health, with exercise intensity adjusted according to kidney function, blood pressure, anemia and overall health.
• Nutritional Support
  A renal dietitian can provide personalised guidance regarding sodium, protein, fluid, potassium and phosphorus intake when these restrictions are clinically required.
• Fatigue and Energy Management
  Activity planning, adequate rest, sleep support and management of anemia or other contributing factors can help patients cope with kidney-related fatigue.
• Blood Pressure and Lifestyle Management
  Patients may receive support with maintaining a healthy weight, limiting excess sodium, avoiding tobacco and following prescribed medicines and monitoring plans.
• Long-Term Functional and Psychological Support
  Counselling and patient education can help patients cope with a chronic kidney condition, dietary changes, repeated investigations and, when necessary, dialysis or transplantation planning.

• Glomerulonephritis treatment depends on the underlying disease and the degree of kidney involvement. ACE inhibitors or ARBs may help control blood pressure and reduce proteinuria, while diuretics can help manage fluid retention and swelling. Individualise medication selection based on the specific glomerular disease, kidney function, blood pressure, proteinuria, infection risk, and other medical conditions.