Post-streptococcal glomerular nephritis: Difference between revisions
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==Background== | ==Background== | ||
#most common cause of acute nephritis worldwide | |||
#risk greatest in children 5-12 years old and adults >60 | |||
#caused by glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus (GAS) | |||
==Diagnosis== | ==Diagnosis== | ||
Most common: | Most common: | ||
#edema | |||
#gross hematuria | |||
#hypertension | |||
Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury) | Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury) | ||
Typically diagnosed by acute nephritis + recent GAS infection | Typically diagnosed by acute nephritis + recent GAS infection | ||
==Work-Up== | |||
#CBC | |||
#Chem 7 | |||
#UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria) | |||
#Strep antigen serology | |||
==DDx== | |||
Insert | |||
==Treatment== | |||
#Supportive management (treat volume overload) | |||
## sodium and water restriction | |||
## lasix (also controls HTN) | |||
## consider dialysis (for acute renal failure) | |||
==Disposition== | |||
#most have complete recovery, particularly children | |||
#resolution begins within the first two weeks | |||
#small subset have late renal complications (ie, hypertension, increasing proteinuria, and renal insufficiency) | |||
==See Also== | ==See Also== | ||
Insert | Insert | ||
==Source== | ==Source== | ||
KajiQuestions | KajiQuestions | ||
[[Category:GU]] | [[Category:GU]] | ||
Revision as of 12:37, 14 March 2011
Background
- most common cause of acute nephritis worldwide
- risk greatest in children 5-12 years old and adults >60
- caused by glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus (GAS)
Diagnosis
Most common:
- edema
- gross hematuria
- hypertension
Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury)
Typically diagnosed by acute nephritis + recent GAS infection
Work-Up
- CBC
- Chem 7
- UA (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria)
- Strep antigen serology
DDx
Insert
Treatment
- Supportive management (treat volume overload)
- sodium and water restriction
- lasix (also controls HTN)
- consider dialysis (for acute renal failure)
Disposition
- most have complete recovery, particularly children
- resolution begins within the first two weeks
- small subset have late renal complications (ie, hypertension, increasing proteinuria, and renal insufficiency)
See Also
Insert
Source
KajiQuestions