Acute nephritic syndrome

Alternative names:

acute glomerulonephritis; glomerulonephritis - acute; nephritis syndrome - acute

Symptoms:

• blood in the urine
• urine that appears dark, cola or tea colored, or cloudy
• decreased urine volume (Little or no urine may be produced.)
• swelling
  • facial swelling
  • swelling around the eye socket (periorbital)
  • arms, hands, feet, legs (dependent edema)
  • abdomen
  • generalized (anasarca)

• general aches and pains (See joint pain, muscle aches.)
• general ill feeling (malaise)
• headache
• blurred vision
• slow, sluggish, lethargic movement

Late symptoms:

• seizures
• decreased alertness, drowsiness, confusion
• nausea, vomiting
• easy bruising or bleeding
• cough containing mucus (mucoid sputum) or pink, frothy material coughed up
• difficulty breathing
  • worse at night
  • that occurs while lying down
  • aggravated by exercise

• flank pain
• blood pressure, high

Signs and tests:

Blood pressure may be elevated. There may be signs of fluid overload (more fluid in the circulation than the heart can effectively pump), including abnormal heart and lung sounds. The jugular (neck) veins may be distended from increased venous pressure. Generalized edema is often present. Examination of the abdomen with the hands (palpation) may indicate fluid overload and enlarged liver. There may be signs of acute renal failure in addition to the above symptoms.

• Urinalysis may show protein, renal tubular cells, blood, white blood cells, and casts.
• Protein, urine test may be positive.
• Urine appearance and color are abnormal
• Azotemia (collection of nitrogen-containing waste products in the blood) may be evidenced by:
  • elevated BUN
  • elevated creatinine

• The creatinine clearance may be decreased.
• A potassium test may be elevated.
• A kidney biopsy reveals glomerulonephritis (inflammation of the glomeruli) and may indicate the cause.

Tests for the cause of the acute nephritic syndrome may include:

• culture of the throat or skin
• blood culture
• ANA titer (lupus)
• serum complement (C3 and C4)
• ANCA (antinutrophil cytoplasmic antibody for vasculitis)
• anti-glomerular basement membrane antibody