Post -infectious glomerulonephritis is an inflammatory process in the kidney corpuscles (medical term glomeruli). The cause of the disease lies in a reaction of the immune system to a certain type of pathogen, the so-called nephritogenic streptococci. In the majority of cases, post-infectious glomerulonephritis occurs between the ages of two and ten in the affected patients. In addition, observations indicate that males develop post-infectious glomerulonephritis more often than females.
What is post-infectious glomerulonephritis?
Postinfectious glomerulonephritis is sometimes called poststreptococcal glomerulonephritis. Basically, the kidney corpuscles are acutely inflamed as part of the disease. As a rule, post-infectious glomerulonephritis develops a few weeks after the organism has been infected with a special form of streptococci. See howsmb for Catatonia Definition and Meaning.
The disease often develops in the first to fourth week after such an infection. It can be observed that post-infectious glomerulonephritis is increasingly being triggered by other types of pathogens. These include, for example, various viral and bacterial pathogens, but also parasites and fungi.
The immune complexes accumulate within the capillaries of the kidney corpuscles, causing damage to the organ. Because the accumulation of substances stimulates the so-called complement system. As a result, various symptoms appear in people suffering from post-infectious glomerulonephritis. In many cases, dark-colored urine and hematuria are among the characteristic symptoms.
The most common cause for the development of post-infectious glomerulonephritis is usually infection with so-called nephritogenic category A streptococci. Infection with the pathogens is possible either via the respiratory tract or the skin. As a result of the infection, the affected organism forms special antibodies.
On the one hand, these are specialized on the epitopes on the surface of the streptococci, but at the same time on the endogenous kidney corpuscles and their structural composition. The antibodies produced by the immune system accumulate on the surface of the basal membranes of the kidney corpuscles. This results in bulges, which are clearly recognizable during examinations with the electron microscope.
As a result, the organism reacts with inflammation, which is characterized by various features. Certain types of granulocytes cause the release of so-called pro-inflammatory cytokines. In addition, the complement system is stimulated, resulting in the formation of special lysis complexes. Eventually, the basal membrane of the glomeruli becomes damaged.
Due to the inflammatory processes, the endothelial cells swell. In addition, the capillaries close. Post-infectious glomerulonephritis is no longer only triggered by streptococci, but in some cases also by gram-negative germs, fungi or viral germs. Even an infestation of the organism with certain parasites sometimes triggers post-infectious glomerulonephritis.
Symptoms, Ailments & Signs
Post-infectious glomerulonephritis is manifested by special symptoms that indicate the disease during a medical examination. As a rule, the typical symptoms develop about one to three weeks after the causal infection with the pathogens. People suffering from post-infectious glomerulonephritis suffer, for example, from general symptoms such as pain in the head, fever and abdominal pain.
In addition, there is a brownish or dark-colored urine. In addition, proteinuria develops, resulting in so-called periorbital edema. In addition, many patients suffer from hypertension. The dark urine results in particular from the fact that more erythrocytes are excreted from the organism via the urine. This phenomenon is also known as hematuria.
In most cases, the function of the kidneys decreases, while at the same time the production of urine decreases. In addition, it has been shown that treatment with drugs has hardly any effect on the disease. In the majority of cases, post-infectious glomerulonephritis is self-limiting, so that the prognosis is comparatively positive. However, various complications are possible, such as cerebral edema, kidney failure and epileptic seizures.
Diagnosis & course of disease
The doctor makes the diagnosis of post-infectious glomerulonephritis primarily on the basis of the characteristic clinical symptoms of the disease. For this purpose, he carries out an anamnesis with the patient in order to gain insight into the individual complaints. After talking to the person concerned, the doctor examines the symptoms using various methods. Analysis of the urine, which can be used to detect erythrocyte and proteinuria, plays an important role here.
A so-called leukocyte cylinder can also be identified. In addition, typical phenomena such as hyponatraemia and hyperkalemia appear in the case of kidney failure. As a rule, there are no increased concentrations of urea and creatinine. Such examinations usually allow a relatively reliable diagnosis of post-infectious glomerulonephritis.
Post-infectious glomerulonephritis is already a complication of an infectious disease. However, in most cases the prognosis is very good. However, this also depends on whether children or older people are affected. In children, the symptoms usually regress quickly after an acute course. Serious complications can still develop in one to ten percent of sick children.
For unknown reasons, a lightning-like course then occurs, which can lead to renal insufficiency up to kidney failure, cerebral edema and seizures. As part of the kidney failure, patients often need regular dialysis or even a kidney transplant as the disease progresses. Furthermore, the occurrence of cerebral edema is a very serious complication.
In addition to severe headaches, nausea, vomiting and dizziness, breathing difficulties, visual disturbances, disturbances of consciousness up to coma and unusual hiccups are also observed. The severe increase in pressure in the brain often results in displacement and compression of vital brain structures. This leads to life-threatening situations.
In older people, the prognosis for postinfectious glomerulonephritis is often much worse than in children. This is especially true for people who suffer from diabetes, malnutrition or alcoholism. About 20 to 25 percent of all elderly patients who have experienced post-infectious glomerulonephritis die of heart failure, uremia, or kidney failure.
When should you go to the doctor?
Symptoms such as skin infections or water retention indicate post-infectious glomerulonephritis. A doctor’s visit is indicated if the symptoms appear in connection with a viral or bacterial infection. Then the sick person must consult a specialist who can clarify the symptoms and prescribe a suitable medication. The symptoms usually appear a week to a month after a streptococcal infection. In some cases, post-infectious glomerulonephritis resolves on its own.
If the symptoms are only mild and decrease after four to seven days, a doctor’s visit is not absolutely necessary. Children, sick and elderly people as well as pregnant women should always go to the doctor with the disease. In addition to the family doctor, the internist is the right contact person. If the skin is involved, a dermatologist can be consulted. If neurological symptoms appear, the help of a neurologist is required. In the case of severe symptoms, a nephrologist, a urologist or a cardiologist can also be consulted to treat the individual symptoms.
Treatment & Therapy
The treatment of post-infectious glomerulonephritis is tailored to the individual case. If kidney function is impaired, regulation of water and salt balance is necessary. For this purpose, diuretic agents and antihypertensives are usually used. This reduces the risk of high blood pressure and edema. In addition, patients often receive penicillins as a preventive measure.
Preventive measures address the causes of post-infectious glomerulonephritis. The risk of infection can be reduced through hygienic standards.
In the case of post-infectious glomerulonephritis, follow-up care is largely on an outpatient basis and can only be used to support healing. In the majority of cases, the disease subsides after several days without medical treatment. However, the body should be protected here by measures such as bed rest, restricted fluid intake and adherence to a low-sodium and low-protein diet until complete healing. Physical exertion should be avoided.
After the illness with post-infectious glomerulonephritis, a follow-up examination by the family doctor is advisable to clarify whether the kidney function is back to normal. This is particularly important in patients who have had additional complications such as edema or electrolyte imbalances in order to avoid complications.
Furthermore, in severe cases, the doctor may prescribe additional antibiotic treatment to prevent the spread of streptococcus to other people. Here it is important to pay attention to the correct intake. In principle, the prognosis for postinfectious glomerulonephritis is positive.
Young patients usually regain full kidney function. In adults, however, the trend is worse, so that permanent kidney damage can occur here, especially in combination with other risk factors. This should be monitored and monitored over the long term.
You can do that yourself
Since post-infectious glomerulonephritis usually responds very well to medical treatment, a major restriction in everyday life is usually not to be expected.
Children in particular should be offered distraction during longer hospital stays. Regular visits by family and friends are just as much a part of this as meaningful employment. For example, friends and comrades can be brought along to the next visit. Helping with any homework, etc., also makes you think differently and helps you not to miss too much learning material.
Taking diuretic medication means that smaller children have to change their nappies much more often and keep their wet genital area dry. If the child prefers to go to the toilet, help should of course also be offered here, if necessary. Great importance should be attached to good personal hygiene.
It is also the task of the parents to stand by and comfort the little ones when they have fears and worries and to support them with any necessary examinations. Just holding your hand can be enough and effectively reduce stress.