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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Nephrology
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Sequelae of acute nephritis

Most cases of acute nephritis do not cause complications; generally speaking, acute nephritis is a self-healing disease that can recover on its own. Approximately three to four weeks later, the condition can gradually alleviate, with the patient’s urine protein and occult blood decreasing until they disappear and kidney function returns to normal, and the edema can also subside, so generally there won’t be any complications. However, there are a minority of patients whose conditions are prolonged and do not heal, and if the patient's condition persists for three months or even half a year without recovery, it might evolve into chronic nephritis. Also, some patients may experience severe kidney failure, heart failure, and pulmonary infections during acute nephritis, leading to severe consequences. The likelihood of these situations occurring is relatively low.

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Written by Li Liu Sheng
Nephrology
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How to treat acute nephritis?

Acute nephritis is commonly seen in children and is a frequent type of glomerular disease in this group. Typically, one to three weeks prior to the onset, there often is a history of upper respiratory tract infection or skin infection. Subsequently, within one to three weeks, patients may experience gross hematuria and eyelid edema. In severe cases, elevated blood pressure and renal dysfunction may occur. Currently, there are no especially effective treatments for acute nephritis. However, if diagnosed properly and treated timely, the cure rate for acute nephritis is very high. Specifically, during the acute phase of acute nephritis, patients should rest in bed, follow a light diet, and adjust water intake based on urine output. Additionally, if patients with acute nephritis also have a respiratory infection, antibiotics should be administered, generally with penicillin as the first choice. Of course, if patients with acute nephritis have significant edema or markedly elevated blood pressure, it is appropriate to use diuretics and antihypertensive medications to avoid complications like hypertensive encephalopathy and heart failure. If some patients with acute nephritis also develop acute renal failure, timely dialysis treatment should be administered to improve the prognosis of acute nephritis and enhance the effectiveness of treatment.

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Written by Zhou Qi
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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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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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.