What causes acute nephritis?

Written by Hu Lin
Nephrology
Updated on January 22, 2025
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The full name of acute nephritis is post-infectious glomerulonephritis, so as the name suggests, acute nephritis is related to infections. The most common cause is acute streptococcal infection. There are also infections caused by Staphylococcus aureus, Staphylococcus epidermidis, and Gram-negative bacteria. The main pathogenic mechanism is due to a series of immune responses caused by streptococcal infections, leading to an immune complex-mediated glomerulonephritis. The most common sites of infection are the respiratory tract and skin, with a latent period of one to three weeks.

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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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How should acute nephritis be treated?

Patients with acute nephritis generally have a good prognosis after reasonable and standardized treatment, and rarely develop into chronic nephritis. The main means of treating acute nephritis is symptomatic supportive care, requiring patients to rest in bed during the acute phase. At the same time, spicy food should be avoided and salt intake should be appropriately controlled. If the patient has an infection, sensitive antibiotics should be actively selected for treatment. Additionally, diuretics can be appropriately used for patients with edema, and if the patient also has hypertension, antihypertensive drugs may be used to keep blood pressure within an appropriate range. Of course, some severe cases of acute nephritis may lead to heart failure or renal failure, in which case dialysis should be actively pursued. (Specific medication use should be carried out under the guidance of a doctor.)

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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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Will acute nephritis cause facial swelling?

Acute nephritis can also cause facial swelling in patients. The pathological damage in patients with acute nephritis is the diffuse proliferation of glomerular cells, which reduces the glomeruli's ability to filter blood. As a result, patients may experience proteinuria and hematuria. Decreased kidney function in water excretion can lead to water accumulation in the body, causing edema in the lower limbs or facial area. The increase in urinary protein can also increase vascular permeability and decrease plasma osmotic pressure, leading to the movement of water outside the blood vessels. These factors can all cause edema. In the body, water tends to accumulate in areas where tissues are looser, such as the facial area. Thus, it is possible for patients with acute nephritis to experience facial swelling.

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How many days does the fever last in acute nephritis?

Generally speaking, acute nephritis itself does not cause fever symptoms in patients. Acute nephritis can cause visible hematuria and an increase in foamy urine. Some patients may also experience a reduction in urine output, severe edema, kidney failure, and other clinical symptoms. However, fever is not a common symptom caused by acute nephritis itself. If such patients develop a fever, it may be due to lung or gastrointestinal infections caused by acute nephritis, as patients with acute nephritis have lowered immune capabilities and are often prone to bacterial infections in other parts of the body, such as coughing and sputum production. In such cases, the patient might have lung inflammation and would require antibiotic treatment to kill the bacteria. Generally, most patients' conditions can be controlled after 10 to 14 days.