GLOMERULONEPHRITIS (Post-Infectious, Acute or Chronic Glomerulonephritis)
(Post-Infectious, Acute or Chronic Glomerulonephritis)
DESCRIPTIONGlomerulonephritis is an inflammation of the glomeruli (small, round filters in the kidney). Damaged glomeruli cannot effectively filter waste products from the bloodstream. The kidneys are involved. Glomerulonephritis can affect both sexes, all ages, but is most common in children 1 to 11 years of age.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Hospitalization (severe cases).
SIGNS & SYMPTOMS
Mild glomerulonephritis produces no symptoms. Diagnosis is possible only with urine studies. Severe glomerulonephritis produces the following: smoky or slightly red urine; general ill feeling; drowsiness; nausea or vomiting; headaches; fever (sometimes); loss of appetite; decreased urination; fluid accumulation in the child's body, especially puffy eyes and ankles; shortness of breath; high blood pressure; protein in the child's urine; disturbed vision.
CAUSESClassic acute glomerulonephritis follows a streptococcal infection. The most common infection sites are the throat and skin. Kidney symptoms usually begin 2 or 3 weeks after the child's strep infection.
Chronic glomerulonephritis is rare and may have different causes than acute glomerulonephritis.
Exposure to people in public places where strep infections can be transmitted to your child.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should avoid exposure to people with strep infection.
Consult your doctor for antibiotic treatment for your child of any infection that may be strep.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as blood counts, repeated urinalyses to determine the presence of protein or other abnormal elements, and streptococcal antibody titer (a sophisticated blood study).
Radionuclide scan and MRI (See Glossary for all).
POSSIBLE COMPLICATIONSKidney failure, which may require dialysis or other dramatic treatment.
Symptoms subside in 2 weeks to several months. Over 90% of children recover without complications. (Adults recover also -- but more slowly).
Record your child's temperature 3 times a day.
Collect and record the amount of urine your child passes in each 24-hour period. Some of this collection will be analyzed in the doctor's office.
MEDICATIONCortisone or cytotoxic drugs, if the child's illness is severe.
Diuretics to increase urination.
Anti-hypertensives, if high blood pressure accompanies the illness.
Iron and vitamin supplements, if anemia develops.
Your doctor may prescribe:
ACTIVITYYour child should stay in bed, except to go to the bathroom, until all signs of illness have passed. This may be several weeks or months. Bed rest ensures an adequate blood flow to the kidney; blood flow is best when lying down. The child may read or watch TV.
Your child can resume normal activities after recovery. Your doctor will determine when all signs and symptoms have disappeared.
DIET & FLUIDS
As long as your child's kidneys function properly, the child may eat a normal, well-balanced diet. Greatly decrease the sodium in your diet.
OK TO GO TO SCHOOL?Not until your physician clears your child for normal activities.
CALL YOUR DOCTOR IF
Your child has symptoms of glomerulonephritis.
The following occur during treatment: severe headache or convulsion; failure to pass at least 22 ounces of urine in a 24-hour period; fever; skin rash; increased fluid retention; increased nausea, vomiting, or diarrhea.