Acute glomerulonephritis

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Written by Li Liu Sheng
Nephrology
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How long should one with acute nephritis stay in bed for rest?

After the onset of acute nephritis, patients should rest in bed for 2-3 weeks until gross hematuria disappears, blood pressure returns to normal, and edema subsides. If the patient's condition is severe, with complications such as high blood pressure, noticeable edema, and significant hematuria, then bed rest should be extended to 4-6 weeks. Bed rest can increase renal blood flow and improve kidney function, which is beneficial for enhancing treatment effectiveness. Gradually, indoor activity can be increased. If the condition does not worsen after 1-2 weeks, the patient may begin outdoor activities. Patients with mild residual proteinuria and microscopic hematuria should be followed up and closely observed without the need for indefinite bed rest. If urine changes worsen again after activity, further bed rest is necessary. For students who develop acute nephritis, it is advisable to take a break from school to ensure enough rest time for recovery.

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Written by Li Liu Sheng
Nephrology
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Can acute nephritis be cured completely?

The main cause of acute nephritis is related to streptococcal infections. Many patients with acute nephritis often have a history of infections in the throat, upper respiratory tract, or skin before the onset of the disease. Therefore, once acute nephritis occurs, patients often exhibit hematuria, which can be either gross hematuria or microscopic hematuria. Severe cases of acute nephritis may also show swelling of the eyelids and face, as well as the presence of mild to moderate urinary protein. In addition, some severe cases of acute nephritis also show elevated blood pressure, decreased renal function, and overall poor outcomes from acute nephritis. Currently, there are no specific treatments available; the main approach is bed rest and symptomatic treatment. For example, diuretics can be used if there is edema, and antihypertensive drugs can be used if there is a need to lower blood pressure. If an infection still exists, antibiotics are used for treatment. With proper and standardized treatment, the vast majority of acute nephritis cases can be completely cured without recurrence.

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Written by Li Liu Sheng
Nephrology
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How is acute nephritis diagnosed?

The diagnosis of acute nephritis is actually not difficult, focusing on the following key points: 1. A history of upper respiratory or skin infections prior to the onset of the disease. 2. Typical manifestations of acute nephritis syndrome, including hematuria, proteinuria, reduced urine output, edema, and elevated blood pressure. Among these, hematuria is the most important basis for diagnosing acute nephritis, which can be gross hematuria or microscopic hematuria, and proteinuria can be mild or severe. 3. During the acute phase, there can be an increase in anti-O and a decrease in serum complement C3 concentration. 4. It commonly affects adolescents and children. 5. Most cases improve or even recover after four to eight weeks of treatment.

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Written by Li Liu Sheng
Nephrology
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How long does acute nephritis require bed rest?

Acute nephritis is commonly seen in children. Once acute nephritis occurs, the main clinical manifestations in patients typically include hematuria, which can be visible or microscopic. It is also accompanied by varying degrees of edema, elevated blood pressure, and even transient renal failure. As for how long patients with acute nephritis need to stay in bed, current studies suggest a minimum of 2-3 weeks of bed rest. If the patient’s hematuria disappears, urinary protein decreases, and edema subsides, they can gradually start moving out of bed. If the condition remains stable, activities can shift from indoors to outdoors. However, if visible hematuria reoccurs, or if edema reappears after activity, it is necessary to continue bed rest for another 4-6 weeks. Therefore, students suffering from acute nephritis often need to take a leave of absence from school and should be closely monitored for changes in their condition under a doctor's guidance.

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Written by Li Liu Sheng
Nephrology
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How to treat acute nephritis?

Acute nephritis is commonly seen in children. The most typical clinical manifestations of acute nephritis include macroscopic or microscopic hematuria, increased urinary protein, and varying degrees of edema, particularly noticeable in the eyelids and facial areas. There may also be varying degrees of increased blood pressure, and even renal failure can occur. In terms of treatment, there are no specific drugs for acute nephritis; the main approach is symptomatic and supportive treatment. During the acute phase, patients should rest in bed and receive targeted treatment for their complications. If there is severe edema, diuretics may be used appropriately. If there is a significant increase in blood pressure, antihypertensive drugs should be used to control the pressure. In cases of severe heart failure, palpitations, chest tightness, and shortness of breath, diuretics should also be used to alleviate the cardiac load. If the patient experiences oliguria, hyperkalemia, or acute renal failure, temporary dialysis may be necessary. Furthermore, a low-salt, low-fat, and light diet should be maintained to prevent complications from excessive salt intake causing edema and high blood pressure. (Use of medications should be under the guidance of a doctor.)

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Written by Li Liu Sheng
Nephrology
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Acute Nephritis Pathological Characteristics

The pathological features of acute nephritis include enlarged kidneys, and under the light microscope, there is diffuse proliferation of glomeruli, capillary endothelial cells, and mesangial cells. During the acute phase, there can be infiltration of neutrophils and mononuclear cells. In severe cases, constriction or occlusion of the capillary loops occurs, and the renal interstitium has edema and infiltration of inflammatory cells. Under immunofluorescence, there are deposits of IgG and C3 appearing as granular deposits along the glomerular capillary walls and mesangial areas. Under electron microscopy, there are hump-shaped electron-dense deposits beneath the glomerular epithelium. Acute nephritis is commonly seen in children, characterized by a sudden onset and symptoms such as hematuria, increased urinary protein, edema, and elevated blood pressure, even transient renal function decline may occur.

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Written by Zhou Qi
Nephrology
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Is acute nephritis contagious?

Acute nephritis is not contagious. Acute nephritis generally occurs after a patient has a bacterial inflammation of the respiratory tract, such as infections by streptococcus, staphylococcus, and other bacteria affecting the respiratory tract, urinary tract, digestive tract, or skin. This leads to a secondary inflammatory response. These inflammatory immune complexes travel through the bloodstream to the kidneys, causing an inflammatory reaction within the organ. It could also be due to the deposition of immune complexes within the glomeruli, leading to glomerular damage. This disease itself is not contagious. Although these bacteria exist as triggers, they typically do not have the capability to infect other patients. Moreover, even if they were to infect others, it would not necessarily lead to nephritis.

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Written by Li Liu Sheng
Nephrology
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What are the symptoms of acute nephritis?

Acute nephritis is commonly seen in children. Most cases of acute nephritis are preceded by a history of streptococcal infection one to three weeks before the onset. Once acute nephritis occurs, the main symptoms include the development of edema, especially swelling of the eyelids and face after waking up in the morning. Additionally, patients with acute nephritis will also experience hematuria, which can be visible or microscopic, with increased foam in the urine and a change in color, and even a decrease in urine output. Of course, patients with severe acute nephritis will also experience a significant increase in blood pressure, leading to nausea, vomiting, headaches, palpitations, chest tightness, shortness of breath, and an inability to lie flat, resulting in heart failure. Therefore, patients with acute nephritis need to undergo reasonable and standardized treatment to avoid complications.

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Written by Zhou Qi
Nephrology
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Can people with acute nephritis eat beef?

In the acute phase of nephritis, patients are generally required to have a light diet and minimize their protein intake, with their protein intake level being about 80% of that of a normal person. They should primarily consume animal-based proteins, which should account for more than 50% of their intake. This principle is called a high-quality, low-protein diet. Therefore, overall, patients with acute nephritis can eat beef, as it is considered a high-quality protein. However, the amount ingested needs to be limited. The intake of beef should be calculated based on the patient's body weight, with every 100 grams of beef containing 20 grams of protein. The total daily protein intake for patients should be 0.6 to 0.8 grams per kilogram of body weight, including both animal and plant proteins. Patients can use the aforementioned data to calculate how much beef they can eat.

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Written by Zhou Qi
Nephrology
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What are the symptoms of acute nephritis?

All patients with acute nephritis will have abnormalities in routine urinalysis, presenting with hematuria or proteinuria, or both concurrently. However, the severity of the condition varies. Some patients may have a large number of red blood cells in their urine, resulting in gross hematuria, tea-colored urine, light red urine, or urine resembling washed meat. Patients might also experience an increase in urine foam due to a large amount of urinary protein. Additionally, patients may develop acute renal failure, during which they might experience a decrease in urine output. However, all mentioned conditions can gradually improve over the course of three to four weeks, with increases in urine output, normalization of routine urinalysis, and resolution of edema.