Acute Glomerulonephritis

Acute nephritic syndrome is a group of disorders that cause inflammation of the internal kidney structures (specifically, the glomeruli).

In acute glomerulonephritis, the kidneys are normal in size or enlarged and oedematous, and the surface of the kidney may show punctate haemorrhages.

In long-standing progressive chronic glomerulonephritis the kidneys may be normal in size or small with finely granular cortical scarring.

Causes of Acute Glomerulonephritis

Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.

Inflammation disrupts the functioning of the glomerulus, which is the part of the kidney that controls filtering and excretion. This inefficient functioning results in blood and protein appearing in the urine, and the accumulation of excess fluid in the body. Swelling results when protein is lost from the blood stream. (Protein maintains fluid within the blood vessels, and when it is lost the fluid collects in the tissues of the body). Acute nephritic syndrome may be associated with the development of high blood pressure, interstitial inflammation (inflammation of the spaces between the cells of the kidney tissue), and acute kidney failure.

Symptoms of Acute Glomerulonephritis

Many people with glomerulonephritis have no symptoms. When symptoms occur, they are often flu-like, such as general fatigue, nausea, vomiting, loss of appetite, fever, and abdominal and joint pain. These types of general symptoms can continue for up to one month before symptoms of kidney failure appear. Patients whose kidneys are failing will produce only small amounts of urine and have swelling (edema) from fluid build-up.

Symptoms of acute glomerulonephritis usually occur around two to three weeks after a streptococcal infection and begin with swelling. They can progress to high blood pressure, visual disturbances, shortness of breath, blood in the urine, and a reduction in urine production. Chronic glomerulonephritis develops so gradually that it is often not discovered until a routine physical exam. As this condition progresses, it causes high blood pressure, swelling, and other symptoms of kidney failure.

Treatment of Acute Glomerulonephritis

The goal of treatment is to reduce glomerular inflammation. Hospitalization is required for diagnosis and treatment of many forms of acute nephritic syndrome. The cause must be identified and treated. This may include antibiotics or other medications or treatment.

Bedrest may be recommended. The diet may include restriction of salt, fluids, and potassium. Medications may include anti-hypertensive medications to control high blood pressure. Corticosteroids or other anti-inflammatory medications may be used to reduce inflammation.