Acute Glomerulonephritis

Acute Glomerulonephritis

Article
Kidney & Bladder Health
Diseases & Conditions
+2
Contributed byKrish Tangella MD, MBAApr 03, 2018

What are other Names for this Condition? (Also known as/Synonyms)

  • Acute Glomerular Nephritis
  • Acute GN
  • Glomerulonephritis, Acute Type

What is Acute Glomerulonephritis? (Definition/Background Information)

  • Acute Glomerulonephritis (or Acute GN) is the sudden swelling of small regions in the kidney known as glomeruli, which are responsible for filtering blood. It prevents the body from removing excess fluid and waste products through urine
  • Acute Glomerulonephritis is caused by a wide range of other illnesses such as viral infections, immune diseases, or the swelling of blood vessels
  • The signs and symptoms of this kidney disease may include high blood pressure, foamy pink or brown urine, urination problems, or puffiness of the face
  • Although Acute Glomerulonephritis may get better on its own, it is important to seek medical attention immediately. The treatment for the condition may include treating the underlying illness or disease
  • The prognosis of Acute Glomerulonephritis is generally good with early detection and treatment. Children are able to recover faster than adults

Who gets Acute Glomerulonephritis? (Age and Sex Distribution)

  • Acute Glomerulonephritis is often brought on by other illnesses and hence, individuals of any age are susceptible to the condition
  • Children are more likely develop Acute Glomerulonephritis which is caused by strep throat infection
  • Both males and females can be affected
  • The condition can occur in all races and ethnicities

What are the Risk Factors for Acute Glomerulonephritis? (Predisposing Factors)

The risk factors for Acute Glomerulonephritis include:

  • Having a condition which weakens the immune system and increases the risk of chronic infection, such as HIV or hepatitis viral infections
  • Bacterial infections such as strep throat
  • Chronic immune disorders such as systemic lupus erythematosus (SLE), IgA nephropathy, and Goodpasture’s syndrome
  • Conditions that affect the blood vessels, such as Wegener’s disease (granulomatosis with polyangiitis or GPA)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Glomerulonephritis? (Etiology)

Acute Glomerulonephritis is usually the result of an underlying condition or illness, which may include:

  • Strep throat: An excess of antibodies are produced to fight the infection. This may cause an inflammation when they settle in the kidneys
  • Bacterial infection of the heart: The exact mechanism that links this condition to Acute GN is unknown
  • Viral infections: HIV, hepatitis B and hepatitis C infections can lead to the condition
  • Systemic lupus erythematosus (SLE or lupus): This is a chronic disease causing an inflammatory response in different parts of the body, including the kidneys
  • IgA nephropathy: IgA, a type of antibody, deposits in the kidney and causes inflammation and tissue damage
  • Goodpasture’s syndrome: An immune disorder which causes bleeding in the lungs, in addition to swelling of the glomeruli
  • Wegener’s disease and polyarteritis nodosa (autoimmune disorders): These cause the inflammation of small and medium blood vessels including those in the kidney

In some cases of Acute GN, the cause is unknown.

What are the Signs and Symptoms of Acute Glomerulonephritis?

The signs and symptoms of Acute Glomerulonephritis may include:

  • Swollen face, especially observed in the early mornings
  • Brown or pink urine; foaming urine
  • Less frequent urination
  • High blood pressure

How is Acute Glomerulonephritis Diagnosed?

Acute Glomerulonephritis can be diagnosed through the following methods: 

  • A complete medical history and a thorough physical examination
  • Blood test: It can help identify high levels of waste products in blood and the type of infection (if any)
  • Urine test: It can help identify blood and protein in urine
  • Ultrasound scan of the kidneys
  • CT and MRI scan of the abdomen
  • Kidney biopsy:
    • A biopsy of the kidney is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
    • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
    • Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and electron microscopic studies, to assist in the diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are possible Complications of Acute Glomerulonephritis?

If left untreated, Acute Glomerulonephritis can cause severe damage to the kidneys. This may lead to the following conditions:  

  • Nephrotic syndrome: This condition occurs when too much protein is lost in urine. This may lead to increased swelling of the face and limbs, as well as result in increased blood pressure and cholesterol levels
  • Acute kidney failure: It develops when there is severe damage to the kidneys. This can lead to nausea, loss of appetite, and fatigue
  • Chronic glomerulonephritis: It develops slowly over years, as the kidneys are not effectively filtering blood. This may lead to increased swelling of the face, high blood pressure, and blood in urine

How is Acute Glomerulonephritis Treated?

The treatment of Acute Glomerulonephritis depends on the underlying cause of the illness and the severity of the symptoms. The treatment options may include:

  • Administration of antibiotics, if a bacterial infection is the underlying cause; antiviral drugs, if the cause of Acute GN is viral infection
  • Corticosteroids and immune suppressing drugs, if SLE or blood vessel inflammation is the causative factor
  • Plasmapheresis, a process to remove abnormal antibodies from blood, if kidney symptoms are severe
  • Kidney dialysis, to artificially filter blood, if kidney symptoms are severe

If the symptoms are mild, healthcare providers may choose to monitor the symptoms carefully and allow the symptoms to subside on their own.

How can Acute Glomerulonephritis be Prevented?

Acute Glomerulonephritis may not be preventable in many cases. However, certain steps can be taken to reduce the risk factors for the condition that include:

  • Following good hygiene practices such as hand washing (to prevent infection)
  • Treating infections promptly
  • Safe sex practices and avoiding intravenous drug use to reduce risk of HIV and hepatitis
  • Controlling autoimmune conditions through adequate treatment

When an infection which can lead to Acute GN does occur, it is important to seek medical attention to avoid inflammation of the kidneys. 

What is the Prognosis of Acute Glomerulonephritis? (Outcomes/Resolutions)

  • In many cases, Acute Glomerulonephritis may resolve spontaneously on its own. Children are able to recover better than adults
  • The prognosis also depends on the underlying cause, severity of symptoms, and response to treatment
  • If damage to the kidney is severe, a kidney transplant may be needed

Additional and Relevant Useful Information for Acute Glomerulonephritis:

Exposure to hydrocarbon solvents such as paints, fuels (gasoline, petroleum products), vehicular exhaust, glues and adhesives, organic solvent vapors, some aerosols and pesticides, can increase the risk for chronic glomerulonephritis.

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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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