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Nephritic Syndrome, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Acute glomerulonephritis (AGN) is acute inflammatory damage to glomerulus, associated with:

    • Abrupt onset of hematuria with or without RBC casts

    • Acute renal failure manifested by edema,...

Diagnosis

Signs and Symptoms

  • Hematuria:

    • Abrupt onset gross hematuria in 30–40% (coffee- or cola-colored urine)

  • Edema:

    • Periorbital edema

    • Generalized edema more common in infants and children

  • Infectious sourc...

Treatment

Pre-Hospital

Support ABCs 

Initial Stabilization/Therapy

ABCs 

Ed Treatment/Procedures

  • Antibiotics for streptococcal infection:

  • Restrict salt and f...

Follow-Up

Disposition

Admission Criteria

  • Evidence of infectious cause for GN

  • Oliguria, anuria

  • Uremia

  • Elevated creatinine

  • Edema

  • Electrolyte abnormalities

  • Severe hypertension

  • CHF

Discharge Criteria

Mild cases of c...

Pearls and Pitfalls

  • Diagnosis is confirmed by biopsy showing characteristic crescent formation within renal glomeruli.

  • Must obtain thorough history of ongoing or recent infections as possible etiology ...

Additional Reading

  • Ikee  R, Kobayashi  S, Saigusa  T, et al. Impact of hypertension and hypertension-related vascular lesions in IgA nephropathy. Hypertens Res.  2006;29(1):15–22.

  • Kanjanabuch  T, ...

Codes

ICD9

  • 580.0 Acute glomerulonephritis with lesion of proliferative glomerulonephritis

  • 580.9 Acute glomerulonephritis with unspecified pathological lesion in kidney

  • 583.2 Nephritis and nephropathy, no...

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