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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Written by Zhou Qi
Nephrology
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Does acute nephritis easily lead to excessive internal heat?

What is referred to as "getting heated" generally refers to the appearance of herpes around the mouth. In fact, most people carry the herpes virus, which typically does not flare up under normal circumstances. However, when the body's immune system is weakened, the virus can become active. For example, factors like long-term fatigue, lack of sleep, or other illnesses can lead to the reemergence of these sores. They can also appear during acute nephritis, as this condition involves kidney abnormalities or possible symptoms like blood and protein in the urine. Some patients may also experience reduced urine output and acute kidney failure. During acute kidney failure, the immune system is often weakened, which can lead to the reappearance of herpes around the mouth, commonly known as "getting heated."

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Written by Li Liu Sheng
Nephrology
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How long does acute nephritis require bed rest?

Acute nephritis is commonly seen in children. Once acute nephritis occurs, the main clinical manifestations in patients typically include hematuria, which can be visible or microscopic. It is also accompanied by varying degrees of edema, elevated blood pressure, and even transient renal failure. As for how long patients with acute nephritis need to stay in bed, current studies suggest a minimum of 2-3 weeks of bed rest. If the patient’s hematuria disappears, urinary protein decreases, and edema subsides, they can gradually start moving out of bed. If the condition remains stable, activities can shift from indoors to outdoors. However, if visible hematuria reoccurs, or if edema reappears after activity, it is necessary to continue bed rest for another 4-6 weeks. Therefore, students suffering from acute nephritis often need to take a leave of absence from school and should be closely monitored for changes in their condition under a doctor's guidance.

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Written by Zhou Qi
Nephrology
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What are the symptoms of acute nephritis?

All patients with acute nephritis will have abnormalities in routine urinalysis, presenting with hematuria or proteinuria, or both concurrently. However, the severity of the condition varies. Some patients may have a large number of red blood cells in their urine, resulting in gross hematuria, tea-colored urine, light red urine, or urine resembling washed meat. Patients might also experience an increase in urine foam due to a large amount of urinary protein. Additionally, patients may develop acute renal failure, during which they might experience a decrease in urine output. However, all mentioned conditions can gradually improve over the course of three to four weeks, with increases in urine output, normalization of routine urinalysis, and resolution of edema.

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Written by Li Liu Sheng
Nephrology
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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.

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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.