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Post-streptococcal glomerulonephritis (GN)

Glomerulonephritis - post-streptococcal; Post-infectious glomerulonephritis

 

Post-streptococcal glomerulonephritis (GN) is a disorder of the kidneys that occurs after infection with certain strains of streptococcus bacteria.

Causes

 

Post-streptococcal GN is a form of glomerulonephritis . It is caused by an infection with a type of streptococcus bacteria. The infection does not occur in the kidneys, but in a different part of the body, such as the skin or throat.

The strep bacterial infection causes the tiny blood vessels in the filtering units of the kidneys (glomeruli) to become inflamed. This makes the kidneys less able to filter the urine.

Post-streptococcal GN is uncommon today because infections that can lead to the disorder are commonly treated with antibiotics. The disorder may develop 1 to 2 weeks after an untreated throat infection, or 3 to 4 weeks after a skin infection.

It may occur in people of any age, but it most often occurs in children ages 6 through 10. Although skin and throat infections are common in children, post-streptococcal GN is a rare complication of these infections.

Risk factors include:

  • Strep throat
  • Streptococcal skin infections (such as impetigo )

 

Symptoms

 

Symptoms may include any of the following:

  • Decreased urine output
  • Rust-colored urine
  • Swelling (edema), general swelling, swelling of the abdomen, swelling of the face or eyes, swelling of the feet, ankles, hands
  • Visible blood in the urine
  • Joint pain
  • Joint stiffness or swelling

 

Exams and Tests

 

A physical examination shows swelling (edema), especially in the face. Abnormal sounds may be heard when listening to the heart and lungs with a stethoscope ( auscultation ). Blood pressure is often high.

Other tests that may be done include:

  • Anti-DNase B
  • Kidney biopsy (this is usually not needed)
  • Serum ASO (and streptolysin O)
  • Serum complement levels
  • Urinalysis

 

Treatment

 

There is no specific treatment for this disorder. Treatment is focused on relieving symptoms.

  • Antibiotics, such as penicillin, will likely be used to destroy any streptococcal bacteria that remain in the body.
  • Blood pressure medicines and diuretic drugs may be needed to control swelling and high blood pressure.
  • Corticosteroids and other anti-inflammatory medicines are generally not effective.

You may need to limit salt in the diet to control swelling and high blood pressure.

 

Outlook (Prognosis)

 

Post-streptococcal GN usually goes away by itself after several weeks to months.

In small number of adults, it may get worse and lead to long-term (chronic) kidney failure. Sometimes, it can progress to end-stage kidney disease, which requires dialysis and a kidney transplant.

 

Possible Complications

 

Health problems that may result from this disorder include:

  • Acute renal failure
  • Chronic glomerulonephritis
  • Chronic renal disease
  • Congestive heart failure or pulmonary edema
  • End-stage renal disease
  • Hyperkalemia
  • High blood pressure (hypertension)
  • Nephrotic syndrome

 

When to Contact a Medical Professional

 

Call your health care provider if:

  • You have symptoms of post-streptococcal GN
  • You have post-streptococcal GN, and you have decreased urine output or other new symptoms

 

Prevention

 

Treating known streptococcal infections may help prevent post-streptococcal GN.

 

 

Open References

References

Meyrier A. Postinfectious glomerulonephritis. In: Gilbert SJ, Weiner DE, eds. National Kidney Foundation Primer on Kidney Diseases . 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 22.

Pan CG, Avner ED. Glomerulonephritis associated with infections. In: Kliegman RM, Stanton BF, St. Geme, JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2015:chap 511.

 
  • Kidney anatomy

    Kidney anatomy - illustration

    The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

    Kidney anatomy

    illustration

    • Kidney anatomy

      Kidney anatomy - illustration

      The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

      Kidney anatomy

      illustration

    Self Care

     

      Tests for Post-streptococcal glomerulonephritis (GN)

       
         

        Review Date: 9/22/2015

        Reviewed By: Charles Silberberg, DO, private practice specializing in nephrology, affiliated with New York Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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