Symptoms of acute nephritis.

Written by Hu Lin
Nephrology
Updated on January 05, 2025
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The symptoms of acute nephritis are mainly manifested as acute nephritic syndrome, that is, hematuria, proteinuria, edema, hypertension, and transient acute kidney injury. Hematuria is a symptom present in almost all cases of acute nephritis, but it is mostly microscopic hematuria, meaning during examination, the routine urine analysis shows positive occult blood, or red blood cells are found in the urinary sediment. About 40% of the patients may exhibit gross hematuria, where the urine color appears like wash-water or may be bright red, deep tea-colored, and so on. The second symptom is proteinuria, which is also often indicated by a positive urine protein test during routine checks. The third symptom is edema, an early symptom of acute nephritis. Mildly, it presents as swelling of the eyelids in the morning and can spread to the whole body if severe. The fourth symptom is hypertension, with about 80% of patients showing a moderate increase in blood pressure. In severe cases, patients might experience oliguria, with urine output less than 400ml/d, accompanied by transient mild increases in blood creatinine and urea nitrogen, indicating acute kidney injury. This condition is mostly self-limiting, and many patients can recover within a few weeks.

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Nephrology
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Acute nephritis has the following characteristics:

Acute nephritis has the following characteristics: First, patients with acute nephritis often have a history of a precursor upper respiratory tract infection. After catching a cold, patients may develop hematuria, proteinuria, or anuria. Second, patients with acute nephritis will experience a decrease in complement C3 in the blood. After recovery from acute nephritis, complement C3 can restore itself. Third, acute nephritis is self-limiting; generally, the patient's condition will gradually improve over three to four weeks, and recovery can be complete after eight weeks. However, a very small number of patients might experience prolonged illness, evolving into chronic nephritis. Fourth, the pathological characteristic of acute nephritis is diffuse proliferation of capillary endothelial cells, which is a manifestation of pathological damage to the glomeruli.

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Written by Li Liu Sheng
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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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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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Early symptoms of acute nephritis

The occurrence of acute nephritis is related to streptococcal infections and is commonly seen in children. Typically, 1-3 weeks before the onset of acute nephritis, patients often have a history of infections in the throat, upper respiratory tract, or skin. Once acute nephritis occurs, the initial symptoms include hematuria, which can manifest as either gross or microscopic hematuria. There is also the appearance of edema, especially noticeable swelling of the eyelids and facial area upon waking up in the morning, and even a decrease in urine output. Additionally, patients with acute nephritis often experience increased foam in the urine, indicating the presence of proteinuria, as well as general weakness, back pain, nausea, and vomiting. After the onset of acute nephritis, some patients may experience elevated blood pressure and even transient renal failure.

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Written by Zhou Qi
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How long does acute nephritis require hospitalization?

Generally speaking, regardless of the disease, the condition is often stable when patients are discharged from the hospital, including the management of acute nephritis. The length of hospital stay for patients with acute nephritis depends on the individual condition of the patient. If the condition of acute nephritis is mild and the patient does not have obvious symptoms, such as mild proteinuria and hematuria, such patients may be hospitalized for about a week. After assessing the condition and predicting gradual improvement, the patient can be discharged. However, if acute nephritis causes some serious complications and the patient's condition is unstable, such as leading to congestive heart failure, some patients may also develop acute renal failure and severe consequences like lung infections. Before these complications are controlled and stabilized, the patient cannot be discharged, and the hospital stay may even exceed one month.