What to do if acute nephritis worsens?

Written by Li Liu Sheng

Nephrology

Updated on February 19, 2025

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Typically, after two to three weeks of treatment, the condition of most patients with acute nephritis can recover. However, if the condition of acute nephritis worsens, patients should return to bed rest and adopt different treatment methods based on their clinical symptoms.

If the patient presents with edema, it is essential to maintain a low-salt diet, with daily salt intake less than 2-3 grams. Additionally, the patient's blood pressure must be addressed. If there is a significant rise in blood pressure, it is advisable to start with a low dose of diuretics, which can facilitate urination, fluid excretion, and lower blood pressure. If blood pressure control is inadequate, calcium channel blockers should be considered.

Moreover, if a patient with acute nephritis develops acute renal failure, dialysis treatment may be necessary; similarly, if acute heart failure occurs, medications to control blood pressure and dilate blood vessels should be used to reduce the cardiac workload, thereby facilitating recovery from acute nephritis.

(Specific medications should be used under the guidance of a physician.)

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Written by Zhou Qi

Nephrology

57sec

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How long does acute nephritis require hospitalization?

Generally speaking, regardless of the disease, the condition is often stable when patients are discharged from the hospital, including the management of acute nephritis. The length of hospital stay for patients with acute nephritis depends on the individual condition of the patient. If the condition of acute nephritis is mild and the patient does not have obvious symptoms, such as mild proteinuria and hematuria, such patients may be hospitalized for about a week. After assessing the condition and predicting gradual improvement, the patient can be discharged. However, if acute nephritis causes some serious complications and the patient's condition is unstable, such as leading to congestive heart failure, some patients may also develop acute renal failure and severe consequences like lung infections. Before these complications are controlled and stabilized, the patient cannot be discharged, and the hospital stay may even exceed one month.

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Written by Zhou Qi

Nephrology

58sec

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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.

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Written by Hu Lin

Nephrology

1min 9sec

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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 Hu Lin

Nephrology

1min 29sec

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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 Li Liu Sheng

Nephrology

1min 18sec

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What should I do about acute nephritis?

Once acute nephritis occurs, it should be actively treated. The measures for treatment are that during the acute phase, the patient should rest in bed. The bed rest period is generally 2-3 weeks, and continues until the patient's gross hematuria disappears, blood pressure returns to normal, and edema subsides. In addition to resting, it is also necessary to control salt intake in the diet, especially in cases with edema or high blood pressure, where daily salt intake should generally not exceed 3g. Protein should mainly come from lean meat, fish, eggs, and milk. Furthermore, strict management of water intake is crucial, especially in cases of oliguria, where water consumption should be minimized. Additionally, if there is an infection combined with these conditions, sensitive antibiotics should be used for treatment, usually advocating the use of penicillin-type antibiotics; if there is edema, diuretics can be appropriately used; if blood pressure is elevated, antihypertensive drugs can be used. Besides these, for severe acute nephritis patients who also suffer from acute renal failure, dialysis treatment might be necessary. (Medication use should be conducted under the guidance of a doctor.)