How does acute glomerulonephritis form?

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Le Thi Minh Huong - Emergency Medicine Doctor - Department of Resuscitation - Emergency - Vinmec Nha Trang International General Hospital.
Acute glomerulonephritis syndrome is a rapidly progressive glomerulonephritis that results from infectious, immune, or vasculitis. Early diagnosis of acute glomerulonephritis and prompt treatment is important to prevent kidney failure.

1. Acute glomerulonephritis syndrome

Glomerulonephritis is damage to the blood-filtering organs, called the glomeruli. In which, the immune system activates inflammation and proliferation of glomerular tissue, leading to damage to the basement membrane, interstitial cells or capillary endothelium. Damaged kidneys are unable to remove waste and excess fluid from the body. Over time, the kidneys can stop working completely and lead to kidney failure.
Glomerulonephritis develops rapidly and suddenly, and may appear after an infection in the throat or on the skin. Sometimes the disease will go into remission on its own, but there are also cases where the kidneys stop working because they are not treated properly and in time.
The initial symptoms of acute glomerulonephritis syndrome are:
Swollen face, large eye bags in the morning; Blood in the urine, or brown urine; Urinating less than usual. Patients may also experience shortness of breath and cough because of increased fluid in the lungs or high blood pressure. If you have one or all of the above symptoms, see your doctor right away.

2. How does acute glomerulonephritis form?

Many different conditions can lead to glomerulonephritis. Sometimes the disease runs in families or has no obvious cause. Medical conditions that cause acute glomerulonephritis syndrome include:
2.1. Infection 2.1.1 Post-streptococcal glomerulonephritis Glomerulonephritis develops rapidly, approximately 1-2 weeks after the patient has recovered from a throat or skin infection (impetigo).
This is because the body produces more antibodies to fight infection during illness. Once cured, these antibodies are deposited in the glomerulus and cause inflammation. Children are more at risk of developing post-streptococcal glomerulonephritis than adults. However, babies also have the ability to recover quickly.
2.1.2 Bacterial endocarditis Sometimes bacteria can spread through the bloodstream and stay in the heart, infecting one or more heart valves. You have a higher risk of developing this condition if you have a heart defect, such as damage to a heart valve or an artificial heart.
Bacterial endocarditis is associated with glomerular disease, but the connection is unclear and more future studies are needed.
2.1.3 Viral infections Viral infections, such as human immunodeficiency virus (HIV), hepatitis B, and hepatitis C, can trigger glomerulonephritis. In particular, rapidly progressive glomerulonephritis has been reported as a rare complication of hepatitis A.
2.1.4 Infections with other bacteria In addition, acute glomerulonephritis syndrome can also occur after infections caused by other bacteria, viruses, parasites, or fungi. These include diplococci, streptococci, staphylococci, mycobacteria, Corynebacterium bovis and actinobacillus.
2.2 Immune disease If not due to infection, acute glomerulonephritis may be secondary to systemic diseases such as:
Lupus : A chronic inflammatory disease that can affect many parts of the body, including skin, joints, kidneys, blood cells, heart and lungs. Goodpasture syndrome: A rare autoimmune lung disorder that, similar to pneumonia, causes bleeding in the lungs as well as glomerulonephritis. IgA nephropathy: Characterized by recurrent episodes of hematuria, the disease results from the deposition of immunoglobulin A (IgA) in the glomeruli. IgA nephropathy can progress for years without prominent symptoms. 2.3 Vasculitis

Polyarteritis: Affects small and medium-sized blood vessels in many parts of the body, such as the patient's heart, kidneys, and intestines. Wegener's disease (polyarteritis granulomatosis): This form of vasculitis affects small and medium blood vessels in the lungs, upper respiratory tract, and kidneys. 2.4. Other non-infectious causes High blood pressure: Can damage the kidneys and reduce their ability to function properly. Conversely, glomerulonephritis can also lead to high blood pressure because the decline in kidney function can affect sodium processing. Diabetic nephropathy: Can affect anyone with diabetes, and often takes years to develop. Good blood sugar control and stable blood pressure can prevent or slow kidney damage. Focal segmental glomerulonephritis: Characterized by scattered scarring in several glomeruli, this condition is sometimes a complication of another disease or of unknown cause. Other conditions: Including Guillain-Barré syndrome, Wilms tumor irradiation, vaccine-associated or serum sickness... In addition to the causes listed above, streptococcal syndrome Acute kidney failure is also associated with a number of cancers, such as multiple myeloma, lung cancer, and chronic lymphocytic leukemia.

3. Prognosis of acute glomerulonephritis

Most cases of acute bacterial glomerulonephritis recover completely, but some cases develop into a chronic one (about 30% in adults and 10% in children).
The progression of non-infectious acute glomerulonephritis syndrome is highly dependent on the overall health of the patient, as well as whether the underlying disease is well identified and managed. Depending on the initial cause, acute glomerulonephritis can be fully reversible, or progress to end-stage chronic kidney disease. In general, if there are heart, lung or neurological complications, the disease is usually worse and less likely to be reversed.
In acute glomerulonephritis, the main treatment is to use antibiotics early if the cause is infection, otherwise, the underlying disease should be well controlled. Use ACE inhibitors when the acute phase is over and there are signs of transition to chronic. Patients need to follow a salt-reduced diet, monitor blood pressure, and adhere to a long-term routine check-up plan.

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Article referenced source: Mayoclinic.org