What Are the Causes of Kidney Scarring?

Urine analysis
Urine sample and analysis (Image: jarun011/iStock/Getty Images)

Scarring of the kidneys is often presumed when there is persistent elevated urine protein, or serum creatinine. However, doctors are often unable to tell the cause of the scarring unless a biopsy is performed. This can be problematic as doctors are often understandably reluctant to order a biopsy in the absence of serious symptoms because this procedure is not without risk. The lack of information often leaves patients in a quandary because they do not know the cause of their symptoms.

Diabetes

Diabetes is a common cause of kidney scarring. This scarring is progressive and can eventually lead to kidney failure. The incidence of kidney disease caused by diabetes is so high that National Institute of Diabetes, Digestive and Kidney Diseases refers to "the kidney disease of diabetes."

Glomerular disease

Glomerular disease includes diseases that cause scarring of the tiny filters in the kidney called glomeruli. These include IgA nephropathy, focal segmental glomerulonephritis (FSGS), membranoproliferative glomerulonephritis (MPGN), IgM nephropathy, Alport's disease and many others. Most of these diseases are progressive and can eventually lead to renal failure. Treatment is based upon controlling the symptoms rather than eliminating the particular disease. In the early stages of disease, emphasis is often placed on lowering proteinuria and blood pressure. Controlling these symptoms causes the disease to progress more slowly.

Vesicoureteral reflux

According to Children's Memorial Hospital in Chicago, vesicoureteral reflux is "a condition in which urine backs up from the bladder into the kidneys." Although many children outgrow this condition, surgery is sometimes necessary. Close monitoring of kids with vesicoureteral reflux is necessary to prevent scarring. Extra attention must be paid to toilet training because the bladder often becomes abnormally stretched out, causing kids to retain their urine longer than would otherwise be normal. Close monitoring of these kids is necessary to prevent scarring from urinary tract infections.

Pyelonephritis

Pyelonephritis is also called a kidney infection. It often results from an uncontrolled urinary tract infection that has spread to the kidneys. Left unchecked, permanent loss of kidney function can result. Patients should be careful not to mask symptoms with over-the-counter drugs. Prompt treatment with antibiotics is necessary to prevent scarring. Unlike many other kidney diseases, pyelonephritis does not have to cause permanent damage.

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