What are the symptoms of acute nephritis?

Written by Li Liu Sheng
Nephrology
Updated on September 29, 2024
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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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Acute nephritis pathological characteristics

The changes in acute nephritis are characterized by diffuse intracapillary proliferative glomerulonephritis, and the main structures in the kidney are the glomeruli, renal tubules, and renal interstitium. Therefore, pathological examination can be divided into light microscopy, immunofluorescence, and electron microscopy examinations. Under light microscopy, the pathological changes in acute nephritis mainly include proliferation of mesangial and endothelial cells in the glomeruli. In the acute phase, there is significant infiltration of neutrophils and mononuclear cells. Masson's trichrome staining can reveal subepithelial immune complex deposits, and there is also edema and infiltration of inflammatory cells in the interstitium; Immunofluorescence examination shows diffuse coarse granular deposits of immune complexes along the capillary walls and in the mesangial areas, mainly composed of IgG and C3; Under electron microscopy examination, there are hump-like electron-dense deposits beneath the epithelial cells.

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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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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.

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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
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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.