Definition:
Alternative Names:
Causes, incidence, and risk factors:
Symptoms:
Despite the diversity of diseases that cause acute nephritis below, they share many symptoms in common:- Blood in the urine (urine appears dark, tea colored, or cloudy.)
- Decreased urine volume (little or no urine may be produced.)
- Swelling
- facial swelling
- swelling around the eye socket
- arms, hands, feet, legs ( dependent edema )
- abdomen
- generalized
- General aches and pains ( joint pain , muscle aches )
- General ill feeling (malaise)
- Headache
- Blurred vision
- Slow, sluggish, lethargic movement
- Seizures
- Decreased alertness , drowsiness , confusion
- Nausea and vomiting
- Easy bruising or bleeding
- Cough containing mucus or pink, frothy material coughed up
- Difficulty breathing , especially at night, while lying down, or from exercise
- Flank pain
- High blood pressure
Signs and tests:
Your blood pressure may be elevated. There may be signs of fluid overload (more fluid in circulation than the heart can effectively pump), including abnormal heart and lung sounds. The jugular (neck) veins may be distended from increased pressure.Generalized swelling is often present. When examining your abdomen, your health care provider may find signs of fluid overload and an enlarged liver . There may be signs of acute kidney failure in addition to the above symptoms.
- Urinalysis may show protein, renal tubular cells, blood, white blood cells, and casts .
- Protein in the urine test may be positive.
- Urine appearance and color are abnormal.
- Azotemia (nitrogen-containing waste products in the blood) may be evidenced by:
- elevated BUN
- elevated creatinine
- The creatinine clearance may be decreased.
- A potassium test may be elevated.
- A kidney biopsy reveals glomerulonephritis (inflammation of the glomeruli), which may indicate the cause.
- Culture of the throat or skin
- Blood culture
- ANA titer ( lupus )
- Serum complement ( C3 and C4 )
- ANCA (antineutrophil cytoplasmic antibody for vasculitis)
- Anti-glomerular basement membrane antibody
- IgA nephropathy
- Henoch-Schonlein purpura
- Hemolytic uremic syndrome
- Post-streptococcal glomerulonephritis
- SLE or lupus nephritis
- Membranoproliferative GN I
- Membranoproliferative GN II
- Infective endocarditis
- Vasculitis
- Rapidly progressive (crescentic) glomerulonephritis
- Goodpasture's syndrome
- Klebsiella pneumonia
- Abdominal abscesses
- Viral diseases such as mononucleosis , measles , mumps
- Typhoid fever
- Hepatitis
- Syphilis and other sexually transmitted diseases
Treatment:
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.
Other treatment of acute kidney failure may be appropriate.
Support Groups:
For information and support, see kidney disease support groups .Expectations (prognosis):
The probable outcome is variable and depends on the disease responsible for the nephritis. When improvement occurs, symptoms associated with fluid retention (such as swelling and cough) and high blood pressure may resolve in a week or two, while urine tests take months to return to normal.Children tend to do better than adults and usually recover completely. Only rarely do they develop complications or progress to chronic glomerulonephritis .
Adults do not recover quite as well or as rapidly as children. Although recurrence is unusual, at least one-third of adults whose acute nephritic syndrome recurs will eventually develop end-stage kidney disease .
Complications:
- Acute kidney failure
- Chronic kidney failure
- End-stage kidney disease
- High blood pressure
- Congestive heart failure
- Pulmonary edema
- Chronic glomerulonephritis
- Nephrotic syndrome
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