Glomerulonephritis

General Illness Information


Medical Term:

GLOMERULONEPHRITIS

(Post-infectious, Acute  glomerulonephritis)

Common Name: None Specified

Description: Acute glomerulonephritis is an inflammation of the glomeruli that results in sudden appearance of blood in the urine, with clumps of red blood cells (casts) and protein in the urine. It is an immunologic response to an infection  (usually streptococcal) which damages the glomeruli. It can be initiated by other bacterial or viral infections.

Glomeruli are microscopic round structures in the kidney which filter waste substances from the body. Damage to the glomeruli results in buildup of waste substances in the bloodstream which may cause serious consequences.

May affect all ages, but is most common in children 1-10 years old. About 5% of the cases occur after age 50.

Causes: Acute glomerulonephritis may follow: 1) Streptococcal infection , this cause is now not so important with the widespread use of antibiotics to treat streptococcal infections. May also occur with other bacterial infections such as pneumococcus, staphylococcus and meningococcus.; 2) Immune disorders; 3) Viral infections; 4) Leukemia; 5) Unknown causes.

Prevention: Avoid exposure to people with streptococcal infection. Also treat streptococcal infections promptly and aggressively.

Signs & Symptoms

About half of the people with this syndrome have no symptoms.

  • Usually the first symptoms to appear is  from fluid accumulation in the body, especially puffy eyes and ankles;
  • Decreased urination;
  • High blood pressure;
  • Protein in urine;
  • Disturbed night vision (due to high blood pressure);
  • Shortness of breath;
  • Appetite loss;
  • Headaches;
  • General ill feeling;
  • Smoky or slightly red urine;
  • Drowsiness.

Risk Factors

  • Streptococcal infection;
  • Immune disorders.

Diagnosis & Treatment

  • For diagnosis, laboratory studies, such as blood counts, repeated urinalyses to determine the presence of protein or other abnormal elements, streptococcal antibody titer, and kidney-function tests;
  • Further investigations such as a kidney biopsy may be performed to rule out other causes of glomerulonephrits;
  • The goals of treatment are to relieve symptoms and prevent complications.

General Measures:

  • Collect and record the amount of urine passed in each 24 hour period. Some of this collection will be analyzed in the doctors office. Fluid intake is restricted till urine output increases;
  • Decrease salt – no-added salt  till hypertension and swelling resolve;
  • Control high blood pressure with diuretics;
  • Record temperatures 2-3 times a day;
  • Dialysis may be necessary to remove build up of waste substances (such as potassium and urea) from the body;
  • Hospitalization may be required in severe cases.

Medications:

  • Cortisone or cytotoxic drugs, if the illness is severe;
  • Diuretics to increase urination;
  • Antihypertensives, if high blood pressure accompanies the illness;
  • Iron and vitamin supplements, if anemia develops.

Activity:

Stay in bed, except to go to the bathroom, until all signs of illness have passed. Bed rest ensures and adequate blood flow to your kidney; blood flow is best when lying down. Resume normal activities after recovery.

Diet:

  • No-added salt diet till swelling subsides;
  • Protein may need to be restricted if the blood levels of urea  are high;
  • Avoid high potassium foods.

Possible Complications:

  • Kidney failure requiring dialysis;
  • High blood pressure causing damage to the eyes (retinopathy) or  the brain (encephalopathy);
  • Abnormal urinalysis may persist for years (microscopic blood loss in urine);
  • Chronic renal failure (rare).

Prognosis

Usually self-limited to 2-3 weeks. 90% of children recover without complications. Adults recover also, but more slowly.

Other

Nothing Specified.

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