Acute nephritic syndrome

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Kidney anatomy

Glomerulonephritis - acute; Acute glomerulonephritis; Nephritis syndrome - acute

Despite the diversity of diseases that cause acute nephritis below, they share many symptoms in common:

• Blood in the urine (urine appears dark, tea colored, or cloudy.)
• Decreased urine volume (little or no urine may be produced.)
• Swelling
  • facial swelling
  • swelling around the eye socket
  • arms, hands, feet, legs (dependent edema)
  • abdomen
  • generalized
• General aches and pains ( joint pain, muscle aches)
• General ill feeling (malaise)
• Headache
• Blurred vision
• Slow, sluggish, lethargic movement

Late symptoms include the following:

• Seizures
• Decreased alertness , drowsiness , confusion
• Nausea and vomiting
• Easy bruising or bleeding
• Cough containing mucus or pink, frothy material coughed up
• Difficulty breathing , especially at night, while lying down, or from exercise
• Flank pain
• High blood pressure

Your blood pressure may be elevated. There may be signs of fluid overload (more fluid in circulation than the heart can effectively pump), including abnormal heart and lung sounds. The jugular (neck) veins may be distended from increased pressure.

Generalized swelling is often present. When examining your abdomen, your health care provider may find signs of fluid overload and an enlarged liver. There may be signs of acute kidney failure in addition to the above symptoms.

• Urinalysis may show protein, renal tubular cells, blood, white blood cells, and casts .
• Protein in the urine test may be positive.
• Urine appearance and color are abnormal.
• Azotemia (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), which may indicate the cause.

• Culture of the throat or skin
• Blood culture
• ANA titer ( lupus )
• Serum complement (C3 and C4)
• ANCA (antineutrophil cytoplasmic antibody for vasculitis)
• Anti-glomerular basement membrane antibody

Review Date: 09/13/2005
Reviewed By: Robert Mushnick, M.D., Clinical Assistant Professor, SUNY Downstate Health Center, Brooklyn, NY. Review provided by VeriMed Healthcare Network.