What causes acute nephritis?

Written by Hu Lin
Nephrology
Updated on January 22, 2025
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The full name of acute nephritis is post-infectious glomerulonephritis, so as the name suggests, acute nephritis is related to infections. The most common cause is acute streptococcal infection. There are also infections caused by Staphylococcus aureus, Staphylococcus epidermidis, and Gram-negative bacteria. The main pathogenic mechanism is due to a series of immune responses caused by streptococcal infections, leading to an immune complex-mediated glomerulonephritis. The most common sites of infection are the respiratory tract and skin, with a latent period of one to three weeks.

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Written by Zhou Qi
Nephrology
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How long does hematuria last in acute nephritis?

The condition of acute nephritis is generally quite severe. Patients may experience hematuria and proteinuria, with diffuse cellular proliferation in the glomeruli. However, this disease is self-limiting, and the condition can heal on its own. It is important to control the causes of acute nephritis and the complications it may cause to help patients overcome the difficulties. Afterward, the patients' hematuria and proteinuria could potentially disappear. Generally, it takes about 3 to 4 weeks for the urinalysis to turn negative, and some patients may even take up to six months to recover. If recovery takes more than six months, it is possible that the patient's acute nephritis has become chronic nephritis.

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Written by Zhou Qi
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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 Zhou Qi
Nephrology
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Will acute nephritis cause facial swelling?

Acute nephritis can also cause facial swelling in patients. The pathological damage in patients with acute nephritis is the diffuse proliferation of glomerular cells, which reduces the glomeruli's ability to filter blood. As a result, patients may experience proteinuria and hematuria. Decreased kidney function in water excretion can lead to water accumulation in the body, causing edema in the lower limbs or facial area. The increase in urinary protein can also increase vascular permeability and decrease plasma osmotic pressure, leading to the movement of water outside the blood vessels. These factors can all cause edema. In the body, water tends to accumulate in areas where tissues are looser, such as the facial area. Thus, it is possible for patients with acute nephritis to experience facial swelling.

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Written by Li Liu Sheng
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Acute Nephritis Pathological Characteristics

The pathological features of acute nephritis include enlarged kidneys, and under the light microscope, there is diffuse proliferation of glomeruli, capillary endothelial cells, and mesangial cells. During the acute phase, there can be infiltration of neutrophils and mononuclear cells. In severe cases, constriction or occlusion of the capillary loops occurs, and the renal interstitium has edema and infiltration of inflammatory cells. Under immunofluorescence, there are deposits of IgG and C3 appearing as granular deposits along the glomerular capillary walls and mesangial areas. Under electron microscopy, there are hump-shaped electron-dense deposits beneath the glomerular epithelium. Acute nephritis is commonly seen in children, characterized by a sudden onset and symptoms such as hematuria, increased urinary protein, edema, and elevated blood pressure, even transient renal function decline may occur.

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Symptoms of acute nephritis include back pain.

Patients with acute nephritis usually have hematuria as their main symptom. Initially, the condition presents as gross hematuria, but within 1-2 days, the patient transitions to microscopic hematuria, and the gross hematuria disappears. Patients may also experience edema, particularly noticeable in the eyelids and facial area upon waking up in the morning, along with varying degrees of increased urine protein. Typically, acute nephritis patients may also experience nausea, vomiting, abdominal distension, and discomfort in the lower back, but not back pain per se, as back pain is not a symptom of acute nephritis. However, if a patient with acute nephritis does develop back pain, it is crucial to rule out other diseases, such as kidney stones, ureteral stones, acute pyelonephritis, and acute renal infarction, all of which can cause sudden back pain in patients with acute nephritis. Back pain should be taken seriously, and appropriate exams, such as an immediate ultrasound, should be conducted.