7536 - Glomerulonephritis

DBQ: Link to Index of DBQ/Exams by Disability for DC 7536

Definition

Inflammation of the glomeruli (microscopic capillaries surrounded by the Bowman's capsule) in the kidneys which function as filters in urine formation by increasing permeability, and permitting blood cells and proteins to enter the kidneys' filtrate.

Etiology

This condition frequently follows upper respiratory tract infections that are caused by particular strains of streptococci. It may also be related secondarily to multi-system diseases (systemic lupus erythematosus [SLE], diabetes mellitus, etc.), or primary disease (IgA nephropathy).

Signs & Symptoms

Manifestations of the condition include: blood in the urine; excess serum proteins in the blood; red cell casts; nausea; constipation; decreased urine output (oliguria); severe itching; swelling; and high blood pressure. Other signs include: anorexia; irritability; flank pain; dizziness; drowsiness; blurred vision; headache; smoky or coffee-colored urine; and increased urine specific gravity.

Tests

Diagnostic measures include: urinalysis; blood tests; and x-ray or ultrasound examination of the kidneys. Kidney biopsy may help to determine the course of treatment.

Treatment

The following measures of treatment are utilized: hypertension is treated with high blood pressure drugs and a sodium (salt)-restricted diet; swelling (edema) is treated with diuretics; urinary tract infections (UTI) are treated with antibiotics; and kidney failure is treated with dialysis or transplant. In addition, treatment would also include managing the underlying multisystem disease, e.g., see Diagnostic Code: 6350 Lupus erythematosus, systemic (SLE), (disseminated).

Residuals

Medications and low-sodium (salt) diet may be required for long-term control of high blood pressure. Recurrent infections may require a recurring antibiotic regimen. Kidney failure will require lifelong dialysis or kidney transplant.

Special Considerations

  • This disease, (condition), only in its active form , has a 1 year presumptive period and shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied. [38 CFR 3.309 [Disease subject to presumptive service connection], 38 CFR 3.309(a). [chronic disease].

  • May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

  • The new criteria for the Genitourinary Disease and Conditions body system became effective November 14, 2021.  Review both current and historic criteria prior to any reduction for disabilities established before that date.  38 CFR 3.951(a)

  • A report of the Institute of Medicine of the National Academy of Sciences has identified some long-term health effects, listed in the table embedded within 38 CFR 3.317(d), that potentially are associated with the infectious diseases listed in 38 CFR 3.317(c)(2). These health effects and diseases are listed alphabetically and are not categorized by the level of association stated in the National Academy of Sciences report. If a veteran who has or had an infectious disease identified in column A also has a condition identified in column B as potentially related to that infectious disease, VA must determine, based on the evidence in each case, whether the column B condition was caused by the infectious disease for purposes of paying disability compensation. This does not preclude a finding that other manifestations of disability or secondary conditions were caused by an infectious disease. See 38 CFR 3.317(d) - Long-term health effects potentially associated with infectious diseases. 

  • If a Veteran presumed service connected for one of the diseases listed in 38 CFR 3.317(c)(2) is diagnosed with one of the diseases listed in column “B” in the table embedded within 38 CFR 3.317(d) within the time period specified for the disease in the same table, if a time period is specified or, otherwise, at any time, VA will request a medical opinion as to whether it is at least as likely as not that the condition was caused by the Veteran having had the associated disease in column “A” in that same table. See 38 CFR 3.317(d) - Long-term health effects potentially associated with infectious diseases.

  • Rate as renal dysfunction

Notes

  • When evaluating any claim involving loss or loss of use of one or more creative organs, refer to 38 CFR 3.350 of this chapter to determine whether the Veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, there are other conditions in this section which under certain circumstances also establish entitlement to special monthly compensation.

  • GFR, estimated GFR (eGFR), and creatinine-based approximations of GFR will be accepted for evaluation purposes when determined to be appropriate and calculated by a medical professional.