Post-streptococcal glomerular nephritis

Background

-most common cause of acute nephritis worldwide

-risk greatest in children 5-12 years old and adults >60

-caused by glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus (GAS)

Diagnosis

Most common:

1) edema

2) gross hematuria

3) hypertension

Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury)

Typically diagnosed by acute nephritis + recent GAS infection

==Work-Up==

CBCChem 7UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria)Strep antigen serology ==DDx==

Insert ==Treatment==

Supportive management (treat volume overload)1) sodium and water restriction2) lasix (also controls HTN)3) consider dialysis (for acute renal failure) ==Disposition==

-most have complete recovery, particularly children

-resolution begins within the first two weeks

-small subset have late renal complications (ie, hypertension, increasing proteinuria, and renal insufficiency)

See Also

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Source

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