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Acute proliferative glomerulonephritis

acute proliferative glomerulonephritis, chronic proliferative glomerulonephritis
Acute proliferative glomerulonephritis is a disorder of the glomeruli glomerulonephritis, or small blood vessels in the kidneys It is a common complication of bacterial infections, typically skin infection by Streptococcus bacteria types 12, 4 and 1 impetigo but also after streptococcal pharyngitis, for which it is also known as postinfectious or poststreptococcal glomerulonephritis2 It can be a risk factor for future albuminuria3 In adults, the signs and symptoms of infection may still be present at the time when the kidney problems develop, and the terms infection-related glomerulonephritis or bacterial infection-related glomerulonephritis are also used4 Acute glomerulonephritis resulted in 19,000 deaths in 2013 down from 24,000 deaths in 1990 worldwide5


  • 1 Signs and symptoms
  • 2 Causes
  • 3 Pathophysiology
  • 4 Diagnosis
    • 41 Differential diagnosis
  • 5 Prevention
  • 6 Treatment
    • 61 Epidemiology
  • 7 References
  • 8 External links

Signs and symptomsedit


Among the signs and symptoms of acute proliferative glomerulonephritis are the following:

  • Hematuria:6
  • Oliguria7
  • Edema8
  • Hypertension8
  • Fever, headache, malaise, anorexia, nausea9


Acute proliferative glomerulonephritis post-streptococcal glomerulonephritisis is caused by an infection with streptococcus bacteria, usually three weeks after infection, usually of the pharynx or the skin, given the time required to raise antibodies and complement proteins1011 The infection causes blood vessels in the kidneys to develop inflammation, this hampers the renal organs ability to filter urinecitation needed Acute proliferative glomerulonephritis most commonly occurs in children11


The pathophysiology of this disorder is consistent with an immune-complex-mediated mechanism, a type III hypersensitivity reaction This disorder produces proteins that have different antigenic determinants, which in turn have an affinity for sites in the glomerulus As soon as binding occurs to the glomerulus, via interaction with properdin, complement is activated Complement fixation causes the generation of additional inflammatory mediators12

Complement activation is very important in acute proliferative glomerulonephritis Apparently immunoglobulin Ig-binding proteins bind C4BP Complement regulatory proteins FH and FHL-1, may be removed by SpeB, and therefore restrain FH and FHL-1 recruitment in the process of infection13


Acute Glomerulonephritis

The following diagnostic methods can be used for acute proliferative glomerulonephritis:ref name=emed/>

  • Kidney biopsy
  • Complement profile
  • Imaging studies
  • Blood chemistry studies

Clinically, acute proliferative glomerulonephritis is diagnosed following a differential diagnosis between and, ultimately, diagnosis of staphylococcal and streptococcal impetigo Serologically, diagnostic markers can be tested; specifically, the streptozyme test is used and measures multiple streptococcal antibodies: antistreptolysin, antihyaluronidase, antistreptokinase, antinicotinamide-adenine dinucleotidase, and anti-DNAse B antibodies14

Differential diagnosisedit

The differential diagnosis of acute proliferative glomerulonephritisis is based on the following:medical citation needed

  1. Causes of acute glomerulonephritis:
    • IgA Nephropathy
    • Lupus nephritis
    • Type 1 membranoproliferative glomerulonephritis
    • Bacterial endocarditis
    • Shunt nephritis
    • Cryoglobulinemia
  2. Nephrotic syndrome
  3. Causes of generalized edema:
    • Malnutrition
    • Malabsorption
    • Renal affection
    • Liver cell failure
    • Right side heart failure
    • Angioedema


It is unclear whether or not acute proliferative glomerulonephritis ie, poststreptococcal glomerulonephritis can be prevented with early prophylactic antibiotic therapy, with some authorities arguing that antibiotics can prevent development of acute proliferative glomerulonephritis,15 while others reject that antibiotics can prevent acute proliferative glomerulonephritis16


Treatment of acute proliferative glomerulonephritis consists of blood pressure BP control:also a renal biopsy may be needed to be performed at some point A low-sodium diet may be needed when hypertension is present In individuals with oliguric acute kidney injury, the amount of potassium should be controlled17


Acute glomerulonephritis resulted in 19,000 deaths in 2013 down from 24,000 deaths in 19905


  1. ^ GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators 8 October 2016 "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015" Lancet London, England 388 10053: 1545–1602 PMC 5055577  PMID 27733282 doi:101016/S0140-67361631678-6 
  2. ^ Baltimore RS February 2010 "Re-evaluation of antibiotic treatment of streptococcal pharyngitis" Curr Opin Pediatr 22 1: 77–82 PMID 19996970 doi:101097/MOP0b013e32833502e7 
  3. ^ White AV, Hoy WE, McCredie DA May 2001 "Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life" Med J Aust 174 10: 492–6 PMID 11419767 
  4. ^ Nasr SH; Radhakrishnan J; D'Agati VD May 2013 "Bacterial infection-related glomerulonephritis in adults" Kidney Int 83 5: 792–803 PMID 23302723 doi:101038/ki2012407 
  5. ^ a b GBD 2013 Mortality and Causes of Death, Collaborators 17 December 2014 "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013" Lancet 385: 117–71 PMC 4340604  PMID 25530442 doi:101016/S0140-67361461682-2 
  6. ^ Sung HY, Lim CH, Shin MJ, et al December 2007 "A case of post-streptococcal glomerulonephritis with diffuse alveolar hemorrhage" J Korean Med Sci 22 6: 1074–8 PMC 2694628  PMID 18162726 doi:103346/jkms20072261074 permanent dead link
  7. ^ Wilkiins, Lippincott Williams & 2015-01-16 Handbook of Signs & Symptoms Lippincott Williams & Wilkins ISBN 9781496310545 
  8. ^ a b Surgeons, American Academy of Orthopaedic; Physicians, American College of Emergency 2009-11-13 Critical Care Transport Jones & Bartlett Learning p 959 ISBN 9780763712235 
  9. ^ Garfunkel, Lynn C; Kaczorowski, Jeffrey; Christy, Cynthia 2007-07-05 Pediatric Clinical Advisor: Instant Diagnosis and Treatment Elsevier Health Sciences p 223 ISBN 9780323070584 
  10. ^ Marianne Gausche-Hill, Susan Fuchs, Loren Yamamoto, American Academy of Pediatrics, American College of Emergency Physicians "APLS: The Pediatric Emergency Medicine Resource" Jones & Bartlett Learning; 2004
  11. ^ a b "Post-streptococcal glomerulonephritis GN: MedlinePlus Medical Encyclopedia" wwwnlmnihgov Retrieved 2015-10-31 
  12. ^ "Acute Poststreptococcal Glomerulonephritis: Background, Pathophysiology, Epidemiology" 
  13. ^ Rodríguez-Iturbe, B; Batsford, S 2007-03-07 "Pathogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet" Kidney International 71 11: 1094–1104 ISSN 0085-2538 PMID 17342179 doi:101038/sjki5002169 
  14. ^ "Acute Poststreptococcal Glomerulonephritis Workup: Approach Considerations, Hematologic and Blood Chemistry Studies, Urine Studies" emedicinemedscapecom Retrieved 2015-10-31 
  15. ^ Rodriguez-Iturbe, Bernardo; Musser, James M 2008-10-01 "The Current State of Poststreptococcal Glomerulonephritis" Journal of the American Society of Nephrology 19 10: 1855–1864 ISSN 1046-6673 PMID 18667731 doi:101681/ASN2008010092 
  16. ^ Allan H Goroll, Albert G Mulley, Jr Primary Care Medicine: Office Evaluation and Management of The Adult Patient, 6th ed Lippincott Williams & Wilkins; 2011
  17. ^ "Acute Poststreptococcal Glomerulonephritis Treatment & Management: Approach Considerations, Consultations, Long-Term Monitoring" 

External linksedit

  • ICD-10: N008
  • ICD-9-CM: 5800
  • DiseasesDB: 29306
External resources
  • MedlinePlus: 000503
  • eMedicine: med/889

  • Post-infectious glomerulonephritis - Mayo Clinic
  • Group A Streptococcal Infections - National Institute of Allergy and Infectious Diseases
  • Wilkins, Lippincott Williams & 2004-01-01 Rapid Assessment: A Flowchart Guide to Evaluating Signs and Symptoms Lippincott Williams & Wilkins ISBN 9781582552729 

acute diffuse proliferative glomerulonephritis, acute proliferative glomerulonephritis, chronic proliferative glomerulonephritis

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