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Acute glomerulonephritis
How long does it take to cure acute nephritis?
Acute nephritis is commonly seen in children. About 1 to 3 weeks before the onset of acute nephritis, many patients have a history of infections in the throat, upper respiratory tract, or skin. Once acute nephritis occurs, the symptoms typically include obvious signs such as hematuria, edema, and high blood pressure. In severe cases, renal dysfunction may also occur. How long does it take to cure acute nephritis? The duration largely depends on the severity of the patient's condition and the timeliness of the treatment. Most patients with acute nephitis can be cured in about two to three weeks with appropriate treatment. That is to say, after two to three weeks of treatment, the patient's hematuria will disappear, the edema will subside, and the blood pressure will return to normal. At this point, the patient can get out of bed and move around indoors.
The difference between acute nephritis and acute pyelonephritis.
The full name of acute nephritis is acute glomerulonephritis. This disease mainly occurs in children and is often preceded by an infection, such as an upper respiratory tract infection or a skin infection. Typical clinical manifestations of acute glomerulonephritis include sudden hematuria, proteinuria, edema, hypertension, and some patients may exhibit transient azotemia. The severity of the condition varies among patients, with severe cases presenting as oliguric acute renal failure. Acute pyelonephritis, on the other hand, is a type of urinary tract infection. Its main clinical symptoms are fever, chills, frequent urination, urgent urination, painful urination, difficulty urinating, and may also include nausea, vomiting, headache, and general body aches. Its diagnosis is mainly based on the presence of positive urinary leukocytes in the routine urine test, and a clean-catch midstream urine culture greater than 100,000 per milliliter.
What should I do about acute nephritis?
Once acute nephritis occurs, it should be actively treated. The measures for treatment are that during the acute phase, the patient should rest in bed. The bed rest period is generally 2-3 weeks, and continues until the patient's gross hematuria disappears, blood pressure returns to normal, and edema subsides. In addition to resting, it is also necessary to control salt intake in the diet, especially in cases with edema or high blood pressure, where daily salt intake should generally not exceed 3g. Protein should mainly come from lean meat, fish, eggs, and milk. Furthermore, strict management of water intake is crucial, especially in cases of oliguria, where water consumption should be minimized. Additionally, if there is an infection combined with these conditions, sensitive antibiotics should be used for treatment, usually advocating the use of penicillin-type antibiotics; if there is edema, diuretics can be appropriately used; if blood pressure is elevated, antihypertensive drugs can be used. Besides these, for severe acute nephritis patients who also suffer from acute renal failure, dialysis treatment might be necessary. (Medication use should be conducted under the guidance of a doctor.)
Is acute nephritis prone to "excessive internal heat"?
Acute nephritis indeed tends to cause "fire-up," which refers to the viral infection in patients. Typically, the appearance of herpes on the upper lip is colloquially known as "fire-up," but in reality, this is an active manifestation of the herpes virus when the body's immune capacity is low. The human body often carries this virus, and symptoms appear when immunity is low. In the state of acute nephritis, it is easy to result in reduced immunity in patients, thus activating the dormant virus in the body, causing herpes in corresponding areas including the upper lip and corners of the mouth.
Acute nephritis etiology and pathogenesis
The primary cause of acute nephritis is related to antigen-antibody mediated immune damage. This means that when patients with acute nephritis are infected by streptococci, certain components within the streptococci can act as antigens and bind to corresponding antibodies produced in the body, forming immune complexes. These immune complexes circulate through the bloodstream and eventually deposit in the glomeruli. When the complement system is activated, inflammatory cells infiltrate, ultimately leading to the development of acute nephritis. Acute nephritis is a common group of primary glomerular diseases, characterized by a sudden onset, with hematuria, reduced urine output, proteinuria, edema, and hypertension as its most significant features. Once acute nephritis occurs, bed rest is usually required, along with active treatment. After treatment, most patients with acute nephritis can recover fully, with few recurrences.
Acute nephritis clinical manifestations
Acute nephritis is commonly seen in pediatric patients. One to three weeks before the onset of acute nephritis, infections often occur in the throat, upper respiratory tract, and skin. Once acute nephritis occurs, the typical clinical manifestations of the patient are hematuria, which can be gross hematuria or microscopic hematuria. There is also edema, especially noticeable swelling of the eyelids and face after getting up in the morning. Due to the edema and reduced urine output, the patient often experiences a significant increase in blood pressure. Of course, in addition to these clinical manifestations, the patient may also experience irritability, back pain, nausea, loss of appetite, and poor spirit. Patients with acute nephritis can also experience severe complications, such as hypertensive encephalopathy, acute heart failure, acute renal failure, etc. Therefore, acute nephritis must be given sufficient attention and actively treated.
Does acute nephritis cause fever?
Acute nephritis is actually a sterile inflammation, with significant proliferation of cells within the glomeruli, primarily related to immune dysfunction. Therefore, from this perspective, acute nephritis does not show symptoms of fever. However, due to the inflammatory response within the glomeruli causing acute nephritis, patients may experience renal failure. In the state of renal failure, the patient's immune capability further decreases, which could lead to complications from infections, with respiratory infections being the most common, including pneumonia, bronchitis, and acute tonsillitis. These inflammations may cause fever, but this fever is not a direct result of the acute nephritis itself.
Causes of Anemia in Acute Nephritis
Patients with acute nephritis often do not experience anemia. If a patient with acute nephritis develops anemia, further examination is necessary to determine whether rapidly progressive glomerulonephritis is present. The mechanisms of anemia include hemorrhagic anemia, anemia due to the destruction and dissolution of red blood cells, and anemia due to decreased bone marrow hematopoietic capacity. Hemorrhagic anemia is commonly seen in cases of excessive menstrual flow or chronic blood in stools, which can occur in conditions such as liver cirrhosis, gastric ulcer, enteritis, and intestinal cancer. Anemia resulting from the breakdown of red blood cells often occurs in cases of splenomegaly or when the body produces antibodies against red blood cells, leading to autoimmune hemolysis. A decrease in bone marrow hematopoietic capacity is typically seen in related diseases such as leukemia, myeloma, or renal anemia, or when the patient's dietary intake of nutrients is insufficient, leading to reduced bone marrow hematopoietic capacity. Overall, for acute nephritis, if anemia occurs, it is important to identify the cause, which may not be closely related to acute nephritis itself.
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.
What to do if acute nephritis worsens?
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.)