Does acute nephritis cause fever?

Written by Zhou Qi
Nephrology
Updated on April 11, 2025
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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 Li Liu Sheng
Nephrology
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Is acute nephritis serious?

Acute nephritis is commonly seen in children, predominantly affecting male children. Often before the onset, there's a history of upper respiratory tract infection or skin infection. One to three weeks after these infections, patients may develop hematuria, swelling of the eyelids and lower extremities, and increased urinary protein. The severity of acute glomerulonephritis can vary; patients with milder forms of acute glomerulonephritis can be cured through appropriate treatment and standardized medication. However, if acute glomerulonephritis is not detected timely and treated properly, it can lead to severe complications, including uremia, heart failure, hypertensive encephalopathy, and other clinical manifestations. Therefore, acute nephritis must be taken seriously to avoid severe complications. Of course, with proper treatment, most patients with acute nephritis can fully recover and have a good prognosis.

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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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Sequelae of acute nephritis

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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Is acute nephritis easy to treat?

In most cases, acute nephritis is not difficult to treat because the disease itself is self-limiting, meaning that acute nephritis can heal naturally within about 3 to 4 weeks. However, acute nephritis can cause some complications, and in severe cases, it may lead to disability or death. Therefore, when patients with acute nephritis develop serious complications, treatment may be relatively difficult or complications such as pulmonary infections, heart failure, and acute renal failure may occur. But with appropriate treatment, most cases are hopeful to be controlled.

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Written by Li Liu Sheng
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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.