How to treat acute nephritis?

Written by Li Liu Sheng
Nephrology
Updated on September 20, 2024
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Acute nephritis is commonly seen in children and is a frequent type of glomerular disease in this group. Typically, one to three weeks prior to the onset, there often is a history of upper respiratory tract infection or skin infection. Subsequently, within one to three weeks, patients may experience gross hematuria and eyelid edema. In severe cases, elevated blood pressure and renal dysfunction may occur. Currently, there are no especially effective treatments for acute nephritis. However, if diagnosed properly and treated timely, the cure rate for acute nephritis is very high. Specifically, during the acute phase of acute nephritis, patients should rest in bed, follow a light diet, and adjust water intake based on urine output. Additionally, if patients with acute nephritis also have a respiratory infection, antibiotics should be administered, generally with penicillin as the first choice. Of course, if patients with acute nephritis have significant edema or markedly elevated blood pressure, it is appropriate to use diuretics and antihypertensive medications to avoid complications like hypertensive encephalopathy and heart failure. If some patients with acute nephritis also develop acute renal failure, timely dialysis treatment should be administered to improve the prognosis of acute nephritis and enhance the effectiveness of treatment.

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Written by Zhou Qi
Nephrology
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Is acute nephritis contagious?

Acute nephritis is not contagious. Acute nephritis generally occurs after a patient has a bacterial inflammation of the respiratory tract, such as infections by streptococcus, staphylococcus, and other bacteria affecting the respiratory tract, urinary tract, digestive tract, or skin. This leads to a secondary inflammatory response. These inflammatory immune complexes travel through the bloodstream to the kidneys, causing an inflammatory reaction within the organ. It could also be due to the deposition of immune complexes within the glomeruli, leading to glomerular damage. This disease itself is not contagious. Although these bacteria exist as triggers, they typically do not have the capability to infect other patients. Moreover, even if they were to infect others, it would not necessarily lead to nephritis.

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Written by Zhou Qi
Nephrology
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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.

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Written by Zhou Qi
Nephrology
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Does acute nephritis easily lead to excessive internal heat?

What is referred to as "getting heated" generally refers to the appearance of herpes around the mouth. In fact, most people carry the herpes virus, which typically does not flare up under normal circumstances. However, when the body's immune system is weakened, the virus can become active. For example, factors like long-term fatigue, lack of sleep, or other illnesses can lead to the reemergence of these sores. They can also appear during acute nephritis, as this condition involves kidney abnormalities or possible symptoms like blood and protein in the urine. Some patients may also experience reduced urine output and acute kidney failure. During acute kidney failure, the immune system is often weakened, which can lead to the reappearance of herpes around the mouth, commonly known as "getting heated."

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Written by Li Liu Sheng
Nephrology
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How is acute nephritis diagnosed?

The diagnosis of acute nephritis is actually not difficult, focusing on the following key points: 1. A history of upper respiratory or skin infections prior to the onset of the disease. 2. Typical manifestations of acute nephritis syndrome, including hematuria, proteinuria, reduced urine output, edema, and elevated blood pressure. Among these, hematuria is the most important basis for diagnosing acute nephritis, which can be gross hematuria or microscopic hematuria, and proteinuria can be mild or severe. 3. During the acute phase, there can be an increase in anti-O and a decrease in serum complement C3 concentration. 4. It commonly affects adolescents and children. 5. Most cases improve or even recover after four to eight weeks of treatment.

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Written by Li Liu Sheng
Nephrology
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What are the symptoms of acute nephritis?

Acute nephritis is commonly seen in children, and in cases of acute nephritis in children, it is often preceded by an upper respiratory tract infection or skin infection one to three weeks prior to the onset. Once acute nephritis occurs, the most prominent clinical symptom in patients is gross hematuria, though some individuals only show microscopic hematuria, accompanied by an increase in urinary proteins. Additionally, patients with acute nephritis may experience swelling of the eyelids and lower limbs, especially noticeable swelling of the eyelids and facial area upon waking in the morning. Some patients may also experience elevated blood pressure, leading to symptoms such as dizziness and headache. A few may suffer from nausea, vomiting, loss of appetite, reduced urine output, or even symptoms of acute renal failure.