Sequelae of acute nephritis

Written by Zhou Qi
Nephrology
Updated on September 10, 2024
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Most cases of acute nephritis do not cause complications; generally speaking, acute nephritis is a self-healing disease that can recover on its own. Approximately three to four weeks later, the condition can gradually alleviate, with the patient’s urine protein and occult blood decreasing until they disappear and kidney function returns to normal, and the edema can also subside, so generally there won’t be any complications. However, there are a minority of patients whose conditions are prolonged and do not heal, and if the patient's condition persists for three months or even half a year without recovery, it might evolve into chronic nephritis. Also, some patients may experience severe kidney failure, heart failure, and pulmonary infections during acute nephritis, leading to severe consequences. The likelihood of these situations occurring is relatively low.

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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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Is acute nephritis contagious?

Acute nephritis is not contagious. Although acute nephritis often follows a history of streptococcal infection, when such streptococci infect the human body, they can cause an immune complex reaction, which circulates through the bloodstream to the kidneys causing inflammation. Furthermore, these streptococci can have a cross-immune reaction with kidney tissue. These mechanisms together lead to diffuse proliferation of glomerular capillary cells, causing hematuria, proteinuria, and even renal failure. However, this condition generally is not contagious. Although this disease is related to streptococcal infection, these streptococci are mostly opportunistic pathogens and are unlikely to cause harm to people other than the patient, making it difficult to trigger a nephritis reaction again.

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How many days does the fever last in acute nephritis?

Generally speaking, acute nephritis itself does not cause fever symptoms in patients. Acute nephritis can cause visible hematuria and an increase in foamy urine. Some patients may also experience a reduction in urine output, severe edema, kidney failure, and other clinical symptoms. However, fever is not a common symptom caused by acute nephritis itself. If such patients develop a fever, it may be due to lung or gastrointestinal infections caused by acute nephritis, as patients with acute nephritis have lowered immune capabilities and are often prone to bacterial infections in other parts of the body, such as coughing and sputum production. In such cases, the patient might have lung inflammation and would require antibiotic treatment to kill the bacteria. Generally, most patients' conditions can be controlled after 10 to 14 days.

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Symptoms of Acute Nephritis

Acute nephritis may present with some clinical symptoms. The main characteristics are that patients may have hematuria and proteinuria. When there is a significant amount of blood in the urine, it can be detected by the naked eye, known as gross hematuria. For instance, the color of the patient's urine could be dark like strong tea or bright red. Patients might also experience increased urine foam due to the presence of proteins in the urine, especially in cases where there is a significant presence of urinary proteins. A minority of patients may experience acute renal failure, often characterized by reduced urine output, or even anuria. Due to the reduced urine output, the water intake of patients cannot be fully excreted, leading to edema. Patients may experience swelling of the facial and bilateral lower limbs or even the whole body.

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What are the symptoms of acute nephritis?

All patients with acute nephritis will have abnormalities in routine urinalysis, presenting with hematuria or proteinuria, or both concurrently. However, the severity of the condition varies. Some patients may have a large number of red blood cells in their urine, resulting in gross hematuria, tea-colored urine, light red urine, or urine resembling washed meat. Patients might also experience an increase in urine foam due to a large amount of urinary protein. Additionally, patients may develop acute renal failure, during which they might experience a decrease in urine output. However, all mentioned conditions can gradually improve over the course of three to four weeks, with increases in urine output, normalization of routine urinalysis, and resolution of edema.