How is acute nephritis diagnosed?

Written by Li Liu Sheng
Nephrology
Updated on November 22, 2024
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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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Nephrology
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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.

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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 Li Liu Sheng
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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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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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Is acute nephritis contagious?

Acute nephritis is not contagious. Acute nephritis generally occurs after a patient has a bacterial inflammation of the respiratory tract, such as infections by streptococcus, staphylococcus, and other bacteria affecting the respiratory tract, urinary tract, digestive tract, or skin. This leads to a secondary inflammatory response. These inflammatory immune complexes travel through the bloodstream to the kidneys, causing an inflammatory reaction within the organ. It could also be due to the deposition of immune complexes within the glomeruli, leading to glomerular damage. This disease itself is not contagious. Although these bacteria exist as triggers, they typically do not have the capability to infect other patients. Moreover, even if they were to infect others, it would not necessarily lead to nephritis.