What to do if acute nephritis worsens?

Written by Li Liu Sheng
Nephrology
Updated on February 19, 2025
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Typically, after two to three weeks of treatment, the condition of most patients with acute nephritis can recover. However, if the condition of acute nephritis worsens, patients should return to bed rest and adopt different treatment methods based on their clinical symptoms.

If the patient presents with edema, it is essential to maintain a low-salt diet, with daily salt intake less than 2-3 grams. Additionally, the patient's blood pressure must be addressed. If there is a significant rise in blood pressure, it is advisable to start with a low dose of diuretics, which can facilitate urination, fluid excretion, and lower blood pressure. If blood pressure control is inadequate, calcium channel blockers should be considered.

Moreover, if a patient with acute nephritis develops acute renal failure, dialysis treatment may be necessary; similarly, if acute heart failure occurs, medications to control blood pressure and dilate blood vessels should be used to reduce the cardiac workload, thereby facilitating recovery from acute nephritis.

(Specific medications should be used under the guidance of a physician.)

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

Acute nephritis is commonly seen in children, and in cases of acute nephritis in children, it is often preceded by an upper respiratory tract infection or skin infection one to three weeks prior to the onset. Once acute nephritis occurs, the most prominent clinical symptom in patients is gross hematuria, though some individuals only show microscopic hematuria, accompanied by an increase in urinary proteins. Additionally, patients with acute nephritis may experience swelling of the eyelids and lower limbs, especially noticeable swelling of the eyelids and facial area upon waking in the morning. Some patients may also experience elevated blood pressure, leading to symptoms such as dizziness and headache. A few may suffer from nausea, vomiting, loss of appetite, reduced urine output, or even symptoms of acute renal failure.

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Is acute nephritis easy to treat?

In most cases, acute nephritis is not difficult to treat because the disease itself is self-limiting, meaning that acute nephritis can heal naturally within about 3 to 4 weeks. However, acute nephritis can cause some complications, and in severe cases, it may lead to disability or death. Therefore, when patients with acute nephritis develop serious complications, treatment may be relatively difficult or complications such as pulmonary infections, heart failure, and acute renal failure may occur. But with appropriate treatment, most cases are hopeful to be controlled.

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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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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.