Principles of Acute Nephritis Treatment

Written by Zhou Qi
Nephrology
Updated on September 17, 2024
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The treatment of acute nephritis mainly involves managing the complications of acute nephritis, because acute nephritis itself can potentially heal automatically. The inflammatory reaction in the glomeruli can naturally subside, and proteinuria can decrease, kidney function can recover. However, acute nephritis may cause some complications that could be life-threatening to the patient. Therefore, treatment should focus on these complications to help the patient overcome difficulties, and then wait for the acute nephritis to heal automatically. Common complications mainly include heart failure, high blood pressure, pulmonary infections, etc. Thus, if a patient experiences heart failure, diuretics or even dialysis may be needed, and if an infection occurs, a full course of antibiotics is necessary for anti-inflammatory treatment.

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Written by Hu Lin
Nephrology
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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.

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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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Written by Li Liu Sheng
Nephrology
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How long does acute nephritis require bed rest?

Acute nephritis is commonly seen in children. Once acute nephritis occurs, the main clinical manifestations in patients typically include hematuria, which can be visible or microscopic. It is also accompanied by varying degrees of edema, elevated blood pressure, and even transient renal failure. As for how long patients with acute nephritis need to stay in bed, current studies suggest a minimum of 2-3 weeks of bed rest. If the patient’s hematuria disappears, urinary protein decreases, and edema subsides, they can gradually start moving out of bed. If the condition remains stable, activities can shift from indoors to outdoors. However, if visible hematuria reoccurs, or if edema reappears after activity, it is necessary to continue bed rest for another 4-6 weeks. Therefore, students suffering from acute nephritis often need to take a leave of absence from school and should be closely monitored for changes in their condition under a doctor's guidance.

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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 Zhou Qi
Nephrology
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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.