Acute nephritic syndromeGlomerulonephritis - acute; Acute glomerulonephritis; Nephritis syndrome - acute
Acute nephritic syndrome is a group of symptoms that occur with some disorders that cause swelling and inflammation of the glomeruli in the kidney, or glomerulonephritis.
Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged....
Acute nephritic syndrome is often caused by an immune response triggered by an infection or other disease.
The immune response is how your body recognizes and defends itself against bacteria, viruses, and substances that appear foreign and harmful....
Common causes in children and adolescents include:
- Hemolytic uremic syndrome
- Henoch-Schönlein purpura
- IgA nephropathy
- Post-streptococcal glomerulonephritis
Common causes in adults include:
- Abdominal abscesses
- Goodpasture syndrome
- Hepatitis B or C
- Infective endocarditis
- Membranoproliferative GN I
- Membranoproliferative GN II
- Rapidly progressive (crescentic) glomerulonephritis
- SLE or lupus nephritis
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the body's immune system mistakenly attacks healthy tissue. It can af...
- Viral diseases such as mononucleosis, measles, mumps
Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.
Measles is a very contagious (easily spread) illness caused by a virus.
The inflammation affects the function of the glomerulus. This is the part of the kidney that filters blood to make urine and remove waste. As a result, blood and protein appear in the urine, and excess fluid builds up in the body.
Swelling of the body occurs when the blood loses a protein called albumin. Albumin keeps fluid in the blood vessels. When it is lost, fluid collects in the body tissues.
Blood loss from the damaged kidney structures leads to blood in the urine.
Blood in the urine
Blood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...
Common symptoms of nephritic syndrome are:
- Blood in the urine (urine appears dark, tea-colored, or cloudy)
- Decreased urine output (little or no urine may be produced)
- Swelling of the face, eye socket, legs, arms, hands, feet, abdomen, or other areas
- High blood pressure
Other symptoms that may occur include:
- Blurred vision, usually from burst blood vessels in the retina of the eye
- Cough containing mucus or pink, frothy material from fluid buildup in the lungs
- Shortness of breath, from fluid buildup in the lungs
- General ill feeling (malaise), drowsiness, confusion, aches and pains, headache
General ill feeling
Malaise is a general feeling of discomfort, illness, or lack of well-being.
Drowsiness refers to feeling abnormally sleepy during the day. People who are drowsy may fall asleep in inappropriate situations or at inappropriate...
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Symptoms of acute kidney failure or chronic kidney disease may develop.
Acute kidney failure
Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your b...
Exams and Tests
During an examination, your health care provider may find the following signs:
- High blood pressure
- Abnormal heart and lung sounds
- Signs of excess fluid (edema) such as swelling in the legs, arms, face, and belly
- Enlarged liver
- Enlarged veins in the neck
Tests that may be done include:
- Blood electrolytes
- Blood urea nitrogen (BUN)
- Creatinine - blood
- Creatinine clearance
- Potassium test
- Protein in the urine
- Urine appearance and color
A kidney biopsy will show inflammation of the glomeruli, which may indicate the cause of the condition.
A kidney biopsy is the removal of a small piece of kidney tissue for examination.
Tests to find the cause of acute nephritic syndrome may include:
- ANA titer (lupus)
The antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are substances produced by the immune system that atta...
- Antiglomerular basement membrane antibody
- Antineutrophil cytoplasmic antibody for vasculitis (ANCA)
- Blood culture
- Culture of the throat or skin
- Serum complement (C3 and C4)
Complement is a blood test that measures the activity of certain proteins in the liquid portion of your blood. The complement system is a group of pr...
Complement C3 is a blood test that measures the activity of a certain protein that is part of the complement system. The complement system is a grou...
The goal of treatment is to reduce inflammation in the kidney and control high blood pressure. You may need to stay in a hospital to be diagnosed and treated.
Your provider may recommend:
- Bedrest until you feel better with treatment
- A diet that limits salt, fluids, and potassium
- Medicines to control high blood pressure, reduce inflammation, or to remove fluid from your body
- Kidney dialysis, if needed
You can often ease the stress of illness by joining support groups where members share common experiences and problems.
The following organizations are good resources for information on kidney disease:National Institute of Diabetes and Digestive and Kidney Disease -- w...
The outlook depends on the disease that is causing the nephritis. When the condition improves, symptoms of fluid retention (such as swelling and cough) and high blood pressure may go away in 1 or 2 weeks. Urine tests may take months to return to normal.
Children tend to do better than adults and usually recover completely. Only rarely do they develop complications or progress to chronic glomerulonephritis and chronic kidney disease.
Adults do not recover as well or as quickly as children. Although it is unusual for the disease to return, in some adults, the disease does return and they will develop end-stage kidney disease and may need dialysis or a kidney transplant.
End-stage kidney disease
End-stage kidney disease is the last stage of chronic kidney disease. This is when your kidneys can no longer support your body's needs. End-stage k...
Artificial kidneys - hemodialysis; Dialysis; Renal replacement therapy - hemodialysis; End-stage renal disease - hemodialysis; Kidney failure - hemod...
A kidney transplant is surgery to place a healthy kidney into a person with kidney failure.
When to Contact a Medical Professional
Call your provider if you have symptoms of acute nephritic syndrome.
Often, the disorder cannot be prevented, although treatment of illness and infection may help to reduce the risk.
Appel GB, Radhakrishnan. Glomerular disorders and nephrotic syndromes. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 121.
Nachman PH, Hennette JC, Falk RJ. Primary glomerular disease. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 31.
Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.
Review Date: 9/22/2015
Reviewed By: Charles Silberberg, DO, private practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.