Acute Glomerulonephritis
Symptoms
o Swelling in the morning, especially in the face, feet, hands, and abdomen Periorbital oedema - puffiness of face
o Follows an episode of sore throat - Streptococcus haemolyticus A strain
o Pain in the loin
o Blood in urine (red, brown, or tea-colored urine)
o Foamy appearance of urine
o Less frequent urination
o Feeling tired
o Dry, itchy skin
o Nausea
o Vomiting
o Poor appetite
o Muscle cramps at night
Lab findings
o Proteinuria
A strip of chemically treated paper will change color when dipped in urine that has too much protein.
Older method - heating the upper part of a test tube of urine - adding acetic acid - a white precipitate formed at the top which does not dissolve in acetic acid
Laboratory tests that measure exact amounts of protein or albumin in the urine are recommended for people at risk for kidney disease, especially those with diabetes.
Urine Analysis
Look for
o blood (RBCs)
o protein,
o bacteria, and
o other evidence of kidney damage in the urine (casts : casts : RBC casts, granular casts, hyaline casts etc.)
Blood Tests
blood urea - raised Normal level 20 - 40 mg%
serum creatinine - raised Normal level 0.8 - 1.2 mg%
Other investigations to be done
Ultrasound Scan
Abdominal CT Scan
Kidney Biopsy (Removal of a sample of kidney tissue with a needle to test for glomerulonephritis )
Treatment
o Diuretics to reduce fluid retention
o Medications to suppress the immune system - Steroids
o Lifestyle Changes
o Restrict salt and water intake
o Restrict intake of potassium, phosphorous, and magnesium
o Cut down on protein in the diet
o Maintain a healthy weight through diet and exercise
o Take calcium supplements .
Prognosis
Chronic glomerulonephritis can lead to kidney failure
The great majority of children with acute glomerulonephritis will recover in a period of weeks to months without complications. Adults tend to recover more slowly.
o The outlook for chronic (ongoing) glomerulonephritis is more variable depending upon the type.
Dialysis and Transplant
o Temporary dialysis
o Permanent kidney failure due to chronic glomerulonephritis may need long-term dialysis or kidney transplant.
measures to be taken
o Prevention
o Treat sore throats well
o Treat diabetes or high blood pressure.
