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Acute Glomerulonephritis

Acute glomerulonephritis refers to a specific set of renal diseases in which an immunologic mechanism
triggers inflammation and proliferation of glomerular tissue. Glomerulonephritis (GN) is the term
generally reserved for the variety of renal diseases in which inflammation of the glomerulus,
manifested by proliferation of cellular elements, is secondary to an immunologic mechanism. Each
kidney is composed of about 1 million microscopic filtering "screens" known as glomeruli that
selectively remove uremic waste products. Chronic glomerulonephritis can develop over a period of
10-20 years and is most often associated with other systemic disease, including diabetes, malaria,
hepatitis, or systemic lupus erythematosus. It can be acute, which means it occurs suddenly, or chronic,
meaning symptoms develop gradually and continue over a number of years. It may be asymptomatic ,
or present with hematuria and/or proteinuria (blood resp. protein in the urine ).
Acute nephritic syndrome is a group of disorders that cause inflammation of the internal kidney
structures (specifically, the glomeruli). There are many recognised types, divided in acute, subacute or
chronic glomerulonephritis. Causes are infectious (bacterial, viral or parasitic pathogens), autoimmune
or paraneoplastic. Acute nephritic syndrome is the clinical correlate of acute glomerular inflammation.
Most forms of AGN are mediated by an immunologic process. Acute glomerulonephritis is an
inflammation of the glomeruli, bundles of tiny vessels inside the kidneys. Chronic glomerulonephritis
can develop over a period of 10-20 years. The effect of these variables on the outcome of the disease is
studied here.The inflammation is immunologically mediated with immune deposits in the glomerulus.
Onset of symptoms is usually acute. The unfavorable prognosis of the disease is due to early mortality
and a rapidly progressive clinical course.

Causes of Acute Glomerulonephritis


Here are the list of the possible causes of Acute Glomerulonephritis :
• The most common cause is postinfectious Streptococcus species (ie, group A, beta-hemolytic).
• Cryoglobulinemia.
• Goodpasteur's syndrome (membranous antiglomerular basement membrane disease).
• The edema first collects in those sites where tissue resistance is low, such as the periorbital area.
• Bacterial causes other than group A streptococci may be diplococcal, streptococcal,
staphylococcal, or mycobacterial.
• Vasculitis (e.g., Wegener's granulomatosis, periarteritis nodosa).
• Post-streptococcal glomerulonephritis.

Symptoms of Acute Glomerulonephritis


Some sign and symptoms related to Acute Glomerulonephritis are as follows :
• Cough with blood-tinged sputum.
• Fever.
• Joint or muscle pain.
• Blood in the urine (urine appears dark, tea colored, or cloudy.)
• facial swelling.
• swelling around the eye socket.
• Slow, sluggish, lethargic movement.
• Difficulty breathing , especially at night, while lying down, or from exercise.
• Foamy urine.
• Seizures.
• Decreased alertness , drowsiness , confusion.

Treatment of Acute Glomerulonephritis


Here is list some of the methods for treating Candidiasis:
• In most patients, acute glomerulonephritis is not an acute life-threatening emergency if the
patient has normal vital signs and lacks underlying illness.
• For glomerulonephritis, treatment consists of antibiotics for any bacterial infection and rest.
• In the presence of fluid overload, diuretics may be used to increase output with urination.
• Hospitalization is required for diagnosis and treatment of many forms of acute nephritic
syndrome.
• Medications may include anti-hypertensive medications to control high blood pressure.
• Corticosteroids or other anti-inflammatory medications may be used to reduce inflammation.
Acute Glomerulonephritis affects the nephron of the kidneys. Risk factors to the development of
Acute Glomerulonephritis are skin infections like impetigo, infections caused by the Group A Beta-
Hemolytic Streptococci, and post streptococcal infections.

Pathophysiology of Acute Glomerulonephritis


With the infections, an antigen-antibody complex forms that causes renal damage especially the
nephrons. The damage to the nephrons allowthe passage of large molecules like the Red blood cell that
causes hematuria and is the primary sign of Acute Glomerulonephritis.
Another large molecule are the Proteins, that causes proteinuria. When proteinuria occurs, there is a
decrese in the osmotic pressure that leads to generalized edema or anasarca. This decreases the
circulating blood volume, which decreases the blood flow and affects the Renin-Angiotensin-
Aldosterone-System, where the Renin promotes vasoconstriction that leads to hypertension.

Signs of Acute Glomerulonephritis


1. Hematuria
2. Hypertension
3. Generalized edema
4. Proteinuria
5. Oliguria
6. Anorexia
7. Nausea and vomiting
Diagnostic Test for Acute Glomerulonephritis
1. Antistreptolysin-O (ASO) Titer.
2. Urinalysis.
3. Renal Biopsy. Is the most confirmatory diagnostic procedure.
4. Increased BUN and Creatinine.

Management for Acute Glomerulonephritis


1. Antibiotics.
2. Antihypertensives.
3. Bed rest.
4. Increase oral fluid intake.

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