Symptoms of acute nephritis recurrence

Written by Zhou Qi
Nephrology
Updated on September 12, 2024
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When acute nephritis recurs, patients may experience a series of symptoms similar to those at the onset of the disease. Patients may present with hematuria, including visible hematuria in some cases. Due to the presence of a significant amount of protein in the urine, patients may develop edema in parts like the lower limbs and eyelids, and in severe cases, edema can become generalized. The presence of protein in urine also leads to increased urine foam. Some patients may experience acute renal failure, a dramatic decrease in urine output, and gastrointestinal reactions such as nausea and vomiting. Patients may also develop hypertension and heart failure, among other conditions.

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Written by Li Liu Sheng
Nephrology
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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.

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Written by Hu Lin
Nephrology
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Acute nephritis pathological characteristics

The changes in acute nephritis are characterized by diffuse intracapillary proliferative glomerulonephritis, and the main structures in the kidney are the glomeruli, renal tubules, and renal interstitium. Therefore, pathological examination can be divided into light microscopy, immunofluorescence, and electron microscopy examinations. Under light microscopy, the pathological changes in acute nephritis mainly include proliferation of mesangial and endothelial cells in the glomeruli. In the acute phase, there is significant infiltration of neutrophils and mononuclear cells. Masson's trichrome staining can reveal subepithelial immune complex deposits, and there is also edema and infiltration of inflammatory cells in the interstitium; Immunofluorescence examination shows diffuse coarse granular deposits of immune complexes along the capillary walls and in the mesangial areas, mainly composed of IgG and C3; Under electron microscopy examination, there are hump-like electron-dense deposits beneath the epithelial cells.

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Written by Hu Lin
Nephrology
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Symptoms of acute nephritis.

The symptoms of acute nephritis are mainly manifested as acute nephritic syndrome, that is, hematuria, proteinuria, edema, hypertension, and transient acute kidney injury. Hematuria is a symptom present in almost all cases of acute nephritis, but it is mostly microscopic hematuria, meaning during examination, the routine urine analysis shows positive occult blood, or red blood cells are found in the urinary sediment. About 40% of the patients may exhibit gross hematuria, where the urine color appears like wash-water or may be bright red, deep tea-colored, and so on. The second symptom is proteinuria, which is also often indicated by a positive urine protein test during routine checks. The third symptom is edema, an early symptom of acute nephritis. Mildly, it presents as swelling of the eyelids in the morning and can spread to the whole body if severe. The fourth symptom is hypertension, with about 80% of patients showing a moderate increase in blood pressure. In severe cases, patients might experience oliguria, with urine output less than 400ml/d, accompanied by transient mild increases in blood creatinine and urea nitrogen, indicating acute kidney injury. This condition is mostly self-limiting, and many patients can recover within a few weeks.

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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 to treat acute nephritis?

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.