Symptoms of acute nephritis recurrence

Written by Zhou Qi
Nephrology
Updated on September 12, 2024
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When acute nephritis recurs, patients may experience a series of symptoms similar to those at the onset of the disease. Patients may present with hematuria, including visible hematuria in some cases. Due to the presence of a significant amount of protein in the urine, patients may develop edema in parts like the lower limbs and eyelids, and in severe cases, edema can become generalized. The presence of protein in urine also leads to increased urine foam. Some patients may experience acute renal failure, a dramatic decrease in urine output, and gastrointestinal reactions such as nausea and vomiting. Patients may also develop hypertension and heart failure, among other conditions.

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Written by Zhou Qi
Nephrology
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Principles of Acute Nephritis Treatment

The treatment of acute nephritis mainly involves managing the complications of acute nephritis, because acute nephritis itself can potentially heal automatically. The inflammatory reaction in the glomeruli can naturally subside, and proteinuria can decrease, kidney function can recover. However, acute nephritis may cause some complications that could be life-threatening to the patient. Therefore, treatment should focus on these complications to help the patient overcome difficulties, and then wait for the acute nephritis to heal automatically. Common complications mainly include heart failure, high blood pressure, pulmonary infections, etc. Thus, if a patient experiences heart failure, diuretics or even dialysis may be needed, and if an infection occurs, a full course of antibiotics is necessary for anti-inflammatory treatment.

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Written by Zhou Qi
Nephrology
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How long does hematuria last in acute nephritis?

The condition of acute nephritis is generally quite severe. Patients may experience hematuria and proteinuria, with diffuse cellular proliferation in the glomeruli. However, this disease is self-limiting, and the condition can heal on its own. It is important to control the causes of acute nephritis and the complications it may cause to help patients overcome the difficulties. Afterward, the patients' hematuria and proteinuria could potentially disappear. Generally, it takes about 3 to 4 weeks for the urinalysis to turn negative, and some patients may even take up to six months to recover. If recovery takes more than six months, it is possible that the patient's acute nephritis has become chronic nephritis.

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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 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 Zhou Qi
Nephrology
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post-acute nephritis sequelae

Acute nephritis is a self-limiting disease, and most patients can fully recover, so the vast majority of patients generally start to show improvement in routine urine tests three to four weeks after onset, with normal kidney function and resolution of edema, resulting in few, if any, sequelae. Of course, a small number of patients may experience prolonged unhealed conditions that can progress to chronic nephritis. These patients may then develop complications, including hypertension and renal anemia, which are long-term potential issues. However, the vast majority of patients with acute nephritis do not experience complications or sequelae.