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Glomerulonephritis, Acute

Dayyan M. Adoor, MD and Jonathan T. Lin, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Acute glomerulonephritis (GN) is an inflammatory process involving the glomerulus of the kidney, resulting in a clinical syndrome consisting of hematuria, proteinuria, and renal insu...

DIAGNOSIS

HISTORY

  • Patients may report cola- or tea-colored urine and decreased urine volume.

  • Edema occurs in many patients, typically in face and lower extremities.

  • Shortness of breath may occur with sig...

TREATMENT

MEDICATION

First Line

  • Hypertension

    • Diuretics are useful for management of salt retention and edema.

    • Calcium channel blockers

    • Avoid ACE inhibitors or ARBs if acute renal dysfunction is present.

  • Per...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Depends on type of GN

  • Regular BP checks and urinalysis to detect recurrence, assessment of renal function to detect acute or follow chronic renal...

REFERENCES

1
Beck L, Bomback AS, Choi MJ, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis. Am J Kidney Dis.  2013;62(3):403–441. [View Abstract on O...

ADDITIONAL READING

  • Bomback AS, Appel GB. Updates on the treatment of lupus nephritis. J Am Soc Nephrol.  2010;21(12):2028–2035. [View Abstract on OvidMedline]

  • Kidney Disease: Improving Global Outc...

CODES

ICD10

  • N00.9 Acute nephritic syndrome with unsp morphologic changes

  • N00.2 Acute nephritic syndrome w diffuse membranous glomrlneph

  • N00.8 Acute nephritic syndrome with other morphologic changes

  • N00.3 ...

CLINICAL PEARLS

  • Dysmorphic RBCs and RBC casts are a key component of the urinalysis in GN.

  • Postinfectious GN in children is typically a self-limited disease.

  • Searching for other organ involvement is use...

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