Acute nephritic syndrome

Acute nephritic syndrome is a syndrome characterized pathologically by diffuse inflammatory changes within glomeruli and clinically by sudden-onset hematuria, red-cell casts, mild proteinuria, often accompanied by hypertension, edema and azotemia.

Common Symptoms

Heart failure; with hypertension; hematuria; nephrotic edematous facies; anuria; oliguria; proteinuria

Causes

Underlying diseases causing acute nephritic syndrome include: (1) Infectious diseases: bacterial, viral and parasitic. (2) Systemic diseases: systemic lupus erythematosus, systemic vasculitis, allergic purpura, essential cryoglobulinemia. (3) Primary glomerular diseases: membranoproliferative nephritis, IgA nephropathy, mesangioproliferative nephritis, focal segmental proliferative nephritis. (4) Others: serum sickness.

Treatment

Medication, supportive treatment

Prevention

As acute nephritis results from autoimmune reaction after hemolytic streptococcus infection, the fundamental prevention is to prevent hemolytic streptococcal infection. Strengthen exercise, improve fitness and resistance, maintain personal hygiene, and avoid upper respiratory, pharyngeal and skin infection. Once such infection occurs, promptly use appropriate antibiotics; penicillin injection (800,000 units IM, twice daily) is best, as it is bactericidal and eradicates local foci and antigens, avoiding autoimmune reaction. This may not absolutely prevent acute nephritis but can stop spread of nephritogenic strains. Check urinalysis continuously for 2-3 weeks after penicillin to detect early. Actively treat recurrent pharyngitis and tonsillitis. Prevention mainly targets related precursor diseases, especially those due to hemolytic streptococcus, such as upper respiratory infection, acute tonsillitis, pharyngitis, scarlet fever and erysipelas; there is an incubation period, about 1-2 weeks for upper respiratory infection and tonsillitis, 2-3 weeks for scarlet fever, and 2-4 weeks for impetigo; timely treatment blocks the immune reaction. Recurrent chronic foci can turn acute into chronic nephritis, so tonsillectomy when appropriate helps. Other bacteria, viruses and protozoa can also cause nephritis, so prompt prevention of precursor disease is important.

Recommended Department

It is recommended to visit the nephrology department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.