Acute nephritis is a condition characterized by inflammation of the kidneys. This condition usually affects children, but adults also can be affected.
What are the symptoms and signs?
This disease is characterized by fairly sudden appearance of swelling of the body. Urine output decreases and urine becomes tea or cola coloured. Breathing difficulty may develop and blood pressure becomes very high. Swelling of the brain and as a result loss of consciousness can occur if there is a sudden increase in blood pressure. This condition is more common children.
What causes nephritis?
This is usually an immunological reaction by the body after an infection. Almost any infection can cause nephritis. Nephritis is most often seen following a streptococcal throat or skin infection. Nephritis usually occurs after a latent period of one to three weeks. But it could occur earlier or later. Several multisystem diseases like systemic lupus erythematosus (SLE) also can result in nephritis.
Who are the most susceptible people?
People of any age group can be affected. Children are more frequently affected than adults as they are more susceptible to develop infections. However, it is uncommon below the age of 3 years.
How is the diagnosis made?
Symptoms and signs are quite characteristic of the disease. Urine examination will show plenty of red blood cells, red cell cast and protein. Kidney functions tests such as creatinine and urea will be slightly deranged or normal. Significant kidney failure is uncommon with acute nephritis.
How long does the illness last?
The symptoms such as swelling, coloured urine, high blood pressure usually persist for few days. However, laboratory abnormalities such as protein leaking blood cells in the urine will persist for several months.
What is the treatment?
Acute nephritis secondary to infection is a self limiting disease. During the ilness, salt and water intake should be restricted (the most important aspect). Diuretics (medicines which increase the urine output) are given to get rid of the extra water, which has accumulated in the body. Blood pressure is controlled with medicines. Infection is treated with appropriate antibiotics.
Can it cause kidney failure?
Acute nephritis in children is mostly a benign condition. Mild impairment of kidney function (characterized by elevated urea and creatinine) may occur, however significant kidney failure is uncommon. In small proportion of patients, a severe kind of nephritis can occur resulting in kidney failure. This condition is called rapidly progressive glomerulonephritis (RPGN). In this condition kidney failure may be severe enough requiring dialysis. Treatment of this condition includes intravenous administration of corticosteroids in high doses. It is important to initiate treatment as early as possible otherwise permanent kidney failure may occur. Diagnosis is condition is made by kidney biopsy and it should be performed in every patient with acute nephritis who has raised urea and creatinine.
Are there any long-term complications?
Acute nephritis is a benign illness in children. Ninety-nine percent of children will not develop any sequalae (Long term problem) as a result of nephritis. The disease is not so benign in adults. 5- 10% of adults may develop problems such as hypertension, protein leaking, kidney failure in the long term. Hence it is important to periodically check the kidney functions adults who develop nephritis.