How long does acute nephritis require bed rest?

Written by Li Liu Sheng
Nephrology
Updated on November 11, 2024
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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 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
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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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.

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Written by Li Liu Sheng
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How to treat acute nephritis?

Acute nephritis is commonly seen in children and is a frequent type of glomerular disease in this group. Typically, one to three weeks prior to the onset, there often is a history of upper respiratory tract infection or skin infection. Subsequently, within one to three weeks, patients may experience gross hematuria and eyelid edema. In severe cases, elevated blood pressure and renal dysfunction may occur. Currently, there are no especially effective treatments for acute nephritis. However, if diagnosed properly and treated timely, the cure rate for acute nephritis is very high. Specifically, during the acute phase of acute nephritis, patients should rest in bed, follow a light diet, and adjust water intake based on urine output. Additionally, if patients with acute nephritis also have a respiratory infection, antibiotics should be administered, generally with penicillin as the first choice. Of course, if patients with acute nephritis have significant edema or markedly elevated blood pressure, it is appropriate to use diuretics and antihypertensive medications to avoid complications like hypertensive encephalopathy and heart failure. If some patients with acute nephritis also develop acute renal failure, timely dialysis treatment should be administered to improve the prognosis of acute nephritis and enhance the effectiveness of treatment.