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Acute

Glomerulonephritis

Adlyanna Velasco

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Definition Acute glomerulonephritis is the

inflammation of the glomeruli whichcauses the kidneys to malfunction

It is also called Acute Nephritis,Glomerulonephritis and Post-Streptococcal Glomerulonephritis

Predominantly affects children from

ages 2 to 12 Incubation period is 2 to 3 weeks

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Causative Agent

Streptococcus pyogenes

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Virulence factor

A capsule made of hyaluronic acid isformed by most S. pyogenes strainscontributes to the bacteriums adhesivenessand because it is chemically

indistinguishable from the HA found inhumans it does not provoke an immuneresponse from the host

Extracellular toxins called streptolysins (O &

S)rapidly injure many cels and tissues

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Culture/Diagnosis

cultivation on sheep blood agar plates

bacitracin disc test

urine dipstick test CBC

kidney biopsy

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Signs and Symptoms

Hematuria: dark brown or smoky urine

Oliguria: urine output is < 400 ml/day

Edema: starts in the eye lids and facethen the lower and upper limbs thenbecomes generalized; may be

migratory

Hypertension: usually mild to moderate

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General Symptoms Fever Headache

Malaise

Anorexia

Nausea and vomiting High blood pressure

Pallor due to edema and/or anemia

Confusion

Lethargy Loss of muscle tissue

Enlargement of the liver

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Complications

Hypertensive encephalopathy, heartfailure and acute pulmonary edema

may occur in severe cases

Acute renal necrosis due to injury ofcapillary or capillary thrombosis

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Prevention

proper hygiene

prompt medical assessment for necessaryantibiotic therapy should be sought when

infection is suspected prophylactic immunizations

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Treatment

Penicillin/Cephalexin

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Nursing InterventionsIndependent: Bedrest helps in maintaining adequate blood flow

to the kidney.

In order to rest the kidney during the acute phase,

decreased sodium and protein intake may berecommended.

Fluid restrictions are adjusted according to thepatient's urinary output and body weight.

An accurate daily record of the patient's weight,

fluid intake and urinary output assist in estimatingkidney function.

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Nursing InterventionsDependent: If residual infection is suspected, antibiotic

therapy may be needed.

In the presence of fluid overload, diuretics

may be used to increase output withurination.

Iron and vitamin supplements may beordered if anemia develops

antihypertensives, if high blood pressureaccompanies the illness.