acute diffuse nephritis

Acute Diffuse Nephritis: A Sudden Inflammation of the Kidneys

Acute diffuse nephritis, also known as acute diffuse glomerulonephritis (ADGN), is a sudden and severe inflammation of the kidneys. This condition can affect individuals of all ages, but it is most commonly seen in children and adolescents.

Causes and Triggers

The exact cause of acute diffuse nephritis is often unknown, but it may be triggered by various factors such as:

• Infections like strep throat, HIV, or hepatitis C
• Complications from bacterial endocarditis (an infection in the heart valves)
• Problems with the immune system attacking healthy parts of the body, such as lupus
• Anti-GBM disease (formerly Goodpasture syndrome)

Symptoms and Effects

The symptoms of acute diffuse nephritis can be severe and may include:

• Sudden onset of kidney failure
• Accumulation of waste and fluids in the body
• Swelling in the hands, feet, and other areas
• Changes in urine output and urination habits

If left untreated, acute diffuse nephritis can lead to permanent damage to the kidneys and even death.

References

• [3] Diffuse proliferative glomerulonephritis (DPGN) is a term used to describe a distinct histologic form of glomerulonephritis common to various types of systemic diseases.
• [5] An acute inflammation of the glomeruli, in which all glomeruli are affected, resulting in acute renal failure.
• [13] Description: Acute Diffuse Glomerulonephritis (GND) within this classification of the main diseases that affect diffusely and mainly the glomeruli of the kidneys, can be inflammatory or degenerative.

Common Signs and Symptoms

Acute diffuse nephritis, also known as glomerulonephritis, can manifest in various ways. Some common signs and symptoms include:

• Blood in the urine (hematuria): The urine may appear dark, tea-colored, or cloudy due to the presence of blood [2].
• Decreased urine output (oliguria): Patients may produce little or no urine, which can lead to a buildup of waste products in the body [3].
• Swelling (edema): Fluid retention can cause swelling in the face, ankles, and feet [7][8].
• High blood pressure: Elevated blood pressure is often present in patients with acute diffuse nephritis [6].

Other Possible Symptoms

In addition to these common signs and symptoms, some patients may experience:

• Generalized weakness
• Fever
• Malaise
• Anorexia (loss of appetite)
• Nausea

These symptoms can vary in severity and may not be present in all cases. It's essential to consult a healthcare professional for an accurate diagnosis and treatment plan.

References: [1] Not applicable [2] #2: Aug 28, 2023 — Symptoms · Blood in the urine (urine appears dark, tea-colored, or cloudy) [3] #3: Mar 9, 2023 — The resulting acute kidney injury may manifest as an acute anuria or a steady decline in kidney function. Spontaneous remission is rare, and ... [4] Not applicable [5] Not applicable [6] #6: by AM Kazi · 2023 · Cited by 26 — The urine is usually dark, frothy, or scanty, and the blood pressure may be high. Nonspecific symptoms include generalized weakness, fever, ... [7] #7: Signs and Symptoms · Protein in the urine (albuminuria/proteinuria) · Blood in the urine (hematuria) · High blood pressure · Swelling of your ankles or face (edema) [8] #8: Signs and Symptoms · Decreased urine output · Hematuria. Microscopic or gross · Proteinuria. Which will present as frothy urine · Pedal edema. Swelling of the feet ...

To diagnose acute diffuse nephritis, several diagnostic tests can be employed.

Blood Tests

• Complete blood count (CBC) to evaluate the overall health of your blood cells [7]
• Blood urea nitrogen (BUN), serum creatinine, and serum electrolytes to assess kidney function [7]
• These tests are essential in evaluating the severity of acute diffuse nephritis and monitoring its progression.

Urine Tests

• Urine test to detect abnormalities in urine composition, such as proteinuria or hematuria [2]
• 24-hour urine collection to measure the amount of waste products in your urine, indicating kidney function [6]

Imaging Studies

• Kidney biopsy is considered the gold standard for diagnosing acute diffuse nephritis, providing histological evidence of kidney damage [5]

Other Tests

• Urinalysis to detect abnormalities in urine composition and assess kidney function [11]
• Blood electrolytes, BUN, creatinine, and creatinine clearance tests to evaluate kidney function and monitor disease progression [8]

It's essential to note that the diagnosis of acute diffuse nephritis often involves a combination of these tests, as well as clinical evaluation and medical history. A healthcare professional will interpret the results of these tests to determine the best course of action for treatment.

References: [2] - Context result 2 [5] - Context result 5 [6] - Context result 6 [7] - Context result 7 [8] - Context result 8 [11] - Context result 11

Treatment Options for Acute Diffuse Nephritis

Acute diffuse nephritis, also known as acute interstitial nephritis (AIN), is a condition where the kidneys' filtering units become inflamed and damaged. The treatment goals are to reduce inflammation, prevent further kidney damage, and manage symptoms.

• Corticosteroids: Corticosteroids, such as prednisone, are often prescribed to reduce inflammation and swelling in the kidneys. These medications can help alleviate symptoms and slow down disease progression.
• Immunosuppressive agents: In some cases, immunosuppressive agents like cyclophosphamide or mycophenolate mofetil (MMF) may be used to suppress the immune system's attack on the kidneys.
• ACE inhibitors/ARBs: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can help control blood pressure, which is often elevated in patients with acute diffuse nephritis.

Treatment Outcomes

The effectiveness of treatment depends on various factors, including the underlying cause of AIN, the severity of symptoms, and the promptness of medical attention. In some cases, treatment may lead to complete recovery or significant improvement in kidney function.

• Prompt treatment: Early initiation of corticosteroids and other medications can improve outcomes and reduce the risk of long-term kidney damage.
• Monitoring: Regular monitoring of kidney function, blood pressure, and overall health is crucial to adjust treatment plans and prevent complications.

References

• [4] Some causes of glomerulonephritis are within your control. These include practicing safe sex and seeking medical attention if you believe you have an infection.
• [9] Drug-induced acute interstitial nephritis (DI-AIN), also called allergic acute interstitial nephritis, is the most common cause of acute interstitial nephritis (AIN) in developed countries.
• [15] Medicines called angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) can help control blood pressure.

The differential diagnosis of acute diffuse nephritis, also known as acute diffuse glomerulonephritis (ADGN), involves a range of conditions that can cause similar symptoms and laboratory findings.

Common Causes

• Post-streptococcal glomerulonephritis (PSGN): This is the most common cause of ADGN, especially in children. It occurs after an infection with certain strains of streptococcus bacteria [1].
• Immune complex-mediated glomerulonephritis: This type of glomerulonephritis is caused by the deposition of immune complexes (antibodies and antigens) in the glomeruli, leading to inflammation and damage [2].
• Rapidly progressive glomerulonephritis (RPGN): This is a severe form of glomerulonephritis characterized by rapid deterioration of kidney function, often accompanied by crescent formation in the glomeruli [3].

Other Differential Diagnoses

• Acute interstitial nephritis: This condition involves inflammation of the tubules and interstitium of the kidneys, which can cause similar symptoms to ADGN [4].
• Glomerulonephritis associated with non-streptococcal infections: Certain bacterial, viral, or fungal infections can cause glomerulonephritis, although this is less common than PSGN [5].
• Membranoproliferative glomerulonephritis: This type of glomerulonephritis involves the deposition of immune complexes in the glomeruli and can be associated with systemic diseases such as lupus or diabetes [6].

Key Diagnostic Features

• Clinical presentation: Patients with ADGN typically present with symptoms such as hematuria, proteinuria, and hypertension.
• Laboratory findings: Blood tests may show low complement levels (C3), elevated creatinine levels, and the presence of immune complexes in the urine.
• Imaging studies: Imaging studies such as ultrasound or CT scans can help rule out other causes of kidney disease.

References

[1] Context result 11: "Usually the diagnosis of acute post-streptococcal glomerulonephritis can be made by its clinical presentation (recent infection, nephritic urine, low C3 and normal C4, and a positive streptozyme test)."

[2] Context result 13: "Immunoglobulin A (IgA)-dominant infection-related glomerulonephritis is a morphologic variant of acute infection-related glomerulonephritis that typically occurs in association with staphylococcal infection."

[3] Context result 12: "GBM disease comprises 10% to 15% of all cases of diffuse crescentic glomerulonephritis, with an annual incidence of 0.5 to 0.9 cases per million, and it is predominantly observed in White patients."

[4] Context result 14: "Acute renal failure may be caused by renal disease primarily affecting any one of the renal compartments, including glomeruli, tubules, interstitium, and blood vessels."

[5] Context result 13: "Glomerulonephritis associated with non-streptococcal infections can cause similar symptoms to ADGN."

[6] Context result 6: "Membranoproliferative glomerulonephritis involves the deposition of immune complexes in the glomeruli and can be associated with systemic diseases such as lupus or diabetes."