What are the symptoms of acute nephritis?

Written by Zhou Qi
Nephrology
Updated on September 27, 2024
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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.

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Written by Zhou Qi
Nephrology
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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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Written by Li Liu Sheng
Nephrology
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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.

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Written by Li Liu Sheng
Nephrology
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acute nephritis symptoms

Acute nephritis is commonly seen in children and occurs more in males than females. It typically begins one to three weeks after an infection, mainly due to a post-streptococcal infection. The main symptom of acute nephritis is the appearance of edema, which is often an initial manifestation. Typically, this includes swelling of the eyelids in the morning, sometimes accompanied by mild swelling of the lower limbs. In addition, a urinalysis of patients might reveal blood, which can appear as either gross hematuria or microscopic hematuria. Furthermore, some patients with acute nephritis may also experience elevated blood pressure, primarily related to the edema. If managed through diuretic treatment, conditions may gradually return to normal. In severe cases of acute nephritis, symptoms can include dizziness, hypertensive encephalopathy, and even reduced urine output leading to acute kidney failure. Therefore, it is crucial to give significant attention to patients with acute nephritis and treat them actively to avoid severe complications.

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Written by Zhou Qi
Nephrology
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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.

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Can people with acute nephritis eat beef?

In the acute phase of nephritis, patients are generally required to have a light diet and minimize their protein intake, with their protein intake level being about 80% of that of a normal person. They should primarily consume animal-based proteins, which should account for more than 50% of their intake. This principle is called a high-quality, low-protein diet. Therefore, overall, patients with acute nephritis can eat beef, as it is considered a high-quality protein. However, the amount ingested needs to be limited. The intake of beef should be calculated based on the patient's body weight, with every 100 grams of beef containing 20 grams of protein. The total daily protein intake for patients should be 0.6 to 0.8 grams per kilogram of body weight, including both animal and plant proteins. Patients can use the aforementioned data to calculate how much beef they can eat.