Acute nephritis clinical manifestations

Written by Li Liu Sheng
Nephrology
Updated on April 12, 2025
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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 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 Zhou Qi
Nephrology
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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.

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Written by Li Liu Sheng
Nephrology
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What are the symptoms of acute nephritis?

Acute nephritis is commonly seen in children, and in cases of acute nephritis in children, it is often preceded by an upper respiratory tract infection or skin infection one to three weeks prior to the onset. Once acute nephritis occurs, the most prominent clinical symptom in patients is gross hematuria, though some individuals only show microscopic hematuria, accompanied by an increase in urinary proteins. Additionally, patients with acute nephritis may experience swelling of the eyelids and lower limbs, especially noticeable swelling of the eyelids and facial area upon waking in the morning. Some patients may also experience elevated blood pressure, leading to symptoms such as dizziness and headache. A few may suffer from nausea, vomiting, loss of appetite, reduced urine output, or even symptoms of acute renal failure.

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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 Hu Lin
Nephrology
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What causes acute nephritis?

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.