Glomerulonephritis, a form of nephritis (inflammation of the kidneys) in which the
lesions involve primarily the glomeruli, is the most common kidney disease. In this
disease, antibodies formed in response to streptococci attach themselves to the
glomerular membrane and injure this membrane. (Glomeruli are the small, coiled mass
of blood capillaries within Bowman's capsule of the kidney.) These damaged glomeruli
allow protein, especially albumin, to filter into Bowman's capsule and, ultimately, to
appear in the urine (albuminuria). The damaged glomeruli also allow red blood cells to
filter into the urine (hematuria). The patient usually recovers without permanent kidney
damage. Sometimes, however, particularly in adult patients, the disease becomes
chronic with a gradual decrease in the number of functioning nephrons. This condition
leads to chronic renal failure.
a. Etiology of Acute Glomerulonephritis. The exact cause of this infection is
unknown. What is known is that a glomerulonephritis infection frequently follows other
infections, especially those of the upper respiratory tract such as a streptococcal
infection. Glomerulonephritis usually occurs in children about one to four weeks after a
streptococcal infection of the throat. There is a latent period of five days to six weeks
between an infection and the onset of nephritis (inflammation of the kidneys).
b. Signs and Symptoms of Acute Glomerulonephritis. A patient with acute
glomerulonephritis may experience the following signs and symptoms:
(1) Hypertension (high arterial blood pressure) - mild to severe from sodium
retention, water retention, or inappropriate renin release. (Renin is an enzyme released
by the kidney into the blood stream, where renin has a part in raising blood pressure
when blood pressure is low.)
Edema (swelling because of the retention of fluid)--may be mild to severe.
(3) Hematuria (discharge of red blood cells in the urine)--resulting in smoky
or coffee-colored urine.
Albuminuria--abnormal amount of albumin excreted each day in the
Oliguria--abnormally low amount of urine excreted per day.