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Acute Nephritic Syndrome (Acute Glomerulonephritis) (Aetiology (Infective…
Acute Nephritic Syndrome (Acute Glomerulonephritis)
Key Facts
Characterised by:
Proteinuria (usually < 2g in 24hrs)
Hypertension and oedema (periorbital, leg or sacral)
Haematuria - visible or non-visible (red cell casts seen on microscopy)
COMMONEST PRIMARY CAUSE is IgA nephropathy
Often caused by an immune response triggered by an infection of other disease
Aetiology
Infective Endocarditis
SLE
Post-streptococcal infection
Systemic sclerosis
Malaria
ANCA associated vasculitis
Schistomiasis
Goodpasture's disease
Hepatitis B & C
IgA nephropathy
Bacterial infection e.g. MRSA , typhoid or secondary syphilis
Clinical Presentation
Oliguria (little urine)
Uraemia and symptoms - anorexia, pruritus, lethargy & nausea
Hypertension (moderate-severe disease increase) and oedema (periorbital, leg or sacral) caused by salt and water retention
Deteriorationg kidney function
Proteinuria - usually less than 2g in 24hrs
Moderate-severe decrease in GFR
Haematuria (mild macrocytic)
Diagnosis
Culture - swab from throat or infected skin
Urine dipstick to detect proteinuria and haematuria
Measure eGFR, proteinuria, serum urea & electrolytes and albumin - to determine current status and monitor progress
Renal biopsy if necessary
Take history to determine cause
Treatment
Treat underlying cause
Hypertension is treated with salt restriction, loop diuretics and calcium channel blockers