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 Li Liu Sheng
Nephrology
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Symptoms of acute nephritis include back pain.

Patients with acute nephritis usually have hematuria as their main symptom. Initially, the condition presents as gross hematuria, but within 1-2 days, the patient transitions to microscopic hematuria, and the gross hematuria disappears. Patients may also experience edema, particularly noticeable in the eyelids and facial area upon waking up in the morning, along with varying degrees of increased urine protein. Typically, acute nephritis patients may also experience nausea, vomiting, abdominal distension, and discomfort in the lower back, but not back pain per se, as back pain is not a symptom of acute nephritis. However, if a patient with acute nephritis does develop back pain, it is crucial to rule out other diseases, such as kidney stones, ureteral stones, acute pyelonephritis, and acute renal infarction, all of which can cause sudden back pain in patients with acute nephritis. Back pain should be taken seriously, and appropriate exams, such as an immediate ultrasound, should be conducted.

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Nephrology
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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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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.

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Written by Zhou Qi
Nephrology
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Symptoms of acute nephritis recurrence

When acute nephritis recurs, patients may experience a series of symptoms similar to those at the onset of the disease. Patients may present with hematuria, including visible hematuria in some cases. Due to the presence of a significant amount of protein in the urine, patients may develop edema in parts like the lower limbs and eyelids, and in severe cases, edema can become generalized. The presence of protein in urine also leads to increased urine foam. Some patients may experience acute renal failure, a dramatic decrease in urine output, and gastrointestinal reactions such as nausea and vomiting. Patients may also develop hypertension and heart failure, among other conditions.

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Written by Li Liu Sheng
Nephrology
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acute nephritis symptoms

Acute nephritis is commonly seen in children and occurs more in males than females. It typically begins one to three weeks after an infection, mainly due to a post-streptococcal infection. The main symptom of acute nephritis is the appearance of edema, which is often an initial manifestation. Typically, this includes swelling of the eyelids in the morning, sometimes accompanied by mild swelling of the lower limbs. In addition, a urinalysis of patients might reveal blood, which can appear as either gross hematuria or microscopic hematuria. Furthermore, some patients with acute nephritis may also experience elevated blood pressure, primarily related to the edema. If managed through diuretic treatment, conditions may gradually return to normal. In severe cases of acute nephritis, symptoms can include dizziness, hypertensive encephalopathy, and even reduced urine output leading to acute kidney failure. Therefore, it is crucial to give significant attention to patients with acute nephritis and treat them actively to avoid severe complications.