Is acute nephritis serious?

Written by Li Liu Sheng
Nephrology
Updated on September 26, 2024
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Acute nephritis is commonly seen in children, predominantly affecting male children. Often before the onset, there's a history of upper respiratory tract infection or skin infection. One to three weeks after these infections, patients may develop hematuria, swelling of the eyelids and lower extremities, and increased urinary protein.

The severity of acute glomerulonephritis can vary; patients with milder forms of acute glomerulonephritis can be cured through appropriate treatment and standardized medication. However, if acute glomerulonephritis is not detected timely and treated properly, it can lead to severe complications, including uremia, heart failure, hypertensive encephalopathy, and other clinical manifestations.

Therefore, acute nephritis must be taken seriously to avoid severe complications. Of course, with proper treatment, most patients with acute nephritis can fully recover and have a good prognosis.

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Written by Li Liu Sheng
Nephrology
1min home-news-image

Is acute nephritis serious?

Acute nephritis is commonly seen in children, predominantly affecting male children. Often before the onset, there's a history of upper respiratory tract infection or skin infection. One to three weeks after these infections, patients may develop hematuria, swelling of the eyelids and lower extremities, and increased urinary protein. The severity of acute glomerulonephritis can vary; patients with milder forms of acute glomerulonephritis can be cured through appropriate treatment and standardized medication. However, if acute glomerulonephritis is not detected timely and treated properly, it can lead to severe complications, including uremia, heart failure, hypertensive encephalopathy, and other clinical manifestations. Therefore, acute nephritis must be taken seriously to avoid severe complications. Of course, with proper treatment, most patients with acute nephritis can fully recover and have a good prognosis.

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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 and is a frequent type of glomerular disease in this group. Typically, one to three weeks prior to the onset, there often is a history of upper respiratory tract infection or skin infection. Subsequently, within one to three weeks, patients may experience gross hematuria and eyelid edema. In severe cases, elevated blood pressure and renal dysfunction may occur. Currently, there are no especially effective treatments for acute nephritis. However, if diagnosed properly and treated timely, the cure rate for acute nephritis is very high. Specifically, during the acute phase of acute nephritis, patients should rest in bed, follow a light diet, and adjust water intake based on urine output. Additionally, if patients with acute nephritis also have a respiratory infection, antibiotics should be administered, generally with penicillin as the first choice. Of course, if patients with acute nephritis have significant edema or markedly elevated blood pressure, it is appropriate to use diuretics and antihypertensive medications to avoid complications like hypertensive encephalopathy and heart failure. If some patients with acute nephritis also develop acute renal failure, timely dialysis treatment should be administered to improve the prognosis of acute nephritis and enhance the effectiveness of treatment.

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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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Symptoms of Acute Nephritis

Acute nephritis may present with some clinical symptoms. The main characteristics are that patients may have hematuria and proteinuria. When there is a significant amount of blood in the urine, it can be detected by the naked eye, known as gross hematuria. For instance, the color of the patient's urine could be dark like strong tea or bright red. Patients might also experience increased urine foam due to the presence of proteins in the urine, especially in cases where there is a significant presence of urinary proteins. A minority of patients may experience acute renal failure, often characterized by reduced urine output, or even anuria. Due to the reduced urine output, the water intake of patients cannot be fully excreted, leading to edema. Patients may experience swelling of the facial and bilateral lower limbs or even the whole body.

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Written by Zhou Qi
Nephrology
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Causes of Anemia in Acute Nephritis

Patients with acute nephritis often do not experience anemia. If a patient with acute nephritis develops anemia, further examination is necessary to determine whether rapidly progressive glomerulonephritis is present. The mechanisms of anemia include hemorrhagic anemia, anemia due to the destruction and dissolution of red blood cells, and anemia due to decreased bone marrow hematopoietic capacity. Hemorrhagic anemia is commonly seen in cases of excessive menstrual flow or chronic blood in stools, which can occur in conditions such as liver cirrhosis, gastric ulcer, enteritis, and intestinal cancer. Anemia resulting from the breakdown of red blood cells often occurs in cases of splenomegaly or when the body produces antibodies against red blood cells, leading to autoimmune hemolysis. A decrease in bone marrow hematopoietic capacity is typically seen in related diseases such as leukemia, myeloma, or renal anemia, or when the patient's dietary intake of nutrients is insufficient, leading to reduced bone marrow hematopoietic capacity. Overall, for acute nephritis, if anemia occurs, it is important to identify the cause, which may not be closely related to acute nephritis itself.