Post-streptococcal glomerulonephritis overview: Difference between revisions
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Renal biopsy is routinely not done to diagnose [[post-streptococcal glomerulonephritis]]. There are the indications for biopsy include persistent [[proteinuria]] of more than 6 months, persistent microscopic [[hematuria]] more than 18 months, decreasing [[GFR]] after 4 weeks, and persistent [[hypocomplementemia]] after 6 weeks. | |||
==Treatment== | ==Treatment== | ||
Revision as of 15:30, 14 June 2018
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Post-streptococcal glomerulonephritis Microchapters |
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Differentiating Post-streptococcal glomerulonephritis from other Diseases |
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Diagnosis |
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Treatment |
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Post-streptococcal glomerulonephritis overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief:
Overview
Historical Perspective
Classification
There is no established system for the classification of post-streptococcal glomerulonephritis.
Pathophysiology
Causes
Differentiating Xyz from Other Diseases
Epidemiology and Demographics
Risk Factors
Common risk factors in the development of post-streptococcal glomerulonephritis include streptococcal throat infection and impetigo. Less common risk factors are household infection with the nephritogenic strain of group A streptococcal.
Screening
There is insufficient evidence to recommend routine screening for post-streptococcal glomerulonephritis.
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Patients with post-streptococcal glomerulonephritis may have a positive history of streptococcal throat infection and streptococcal skin infection. Common symptoms of post-streptococcal glomerulonephritis include dark urine, oliguria, periorbital edema and hypertension. Less common symptoms of post-streptococcal glomerulonephritis include general malaise, weakness, anorexia, nausea and vomiting.
Physical Examination
Laboratory Findings
Electrocardiogram
There are no ECG findings associated with post-streptococcal glomerulonephritis.
X-ray
Echocardiography and Ultrasound
CT scan
There are no CT scan findings associated with post-streptococcal glomerulonephritis.
MRI
There are no MRI findings associated with post-streptococcal glomerulonephritis.
Other Imaging Findings
There are no other imaging findings associated with post-streptococcal glomerulonephritis.
Other Diagnostic Studies
Renal biopsy is routinely not done to diagnose post-streptococcal glomerulonephritis. There are the indications for biopsy include persistent proteinuria of more than 6 months, persistent microscopic hematuria more than 18 months, decreasing GFR after 4 weeks, and persistent hypocomplementemia after 6 weeks.
Treatment
Medical Therapy
The mainstay of treatment is pharmacotherapy, however dietary therapy is useful for controlling edema and hypertension. Dietary therapy includes low salt, protein intake, and water restriction. If the streptococcal infection is still present, it should be treated with antibiotics. To control severe hypertension, labetalol is usually used, For mild to moderate hypertension, furosemide is used. For rapidly progressive crescentic acute post-streptococcal glomerulonephritis, methylprednisolone is preferred.
Surgery
Surgical intervention is not recommended for the management of post-streptococcal glomerulonephritis.
Primary Prevention
Effective measures for the primary prevention of post-streptococcal glomerulonephritis include improving hand hygiene, better housing, prevent overcrowding, treatment of an infected patient within 24 hours with antibiotics and prevent close contact. A 26-valent vaccine is recommended for children to prevent post-streptococcal glomerulonephritis.
Secondary Prevention
Post-streptococcal glomerulonephritis is resolved completely, however, effective measures for the secondary prevention of post-streptococcal glomerulonephritis include compliant with anti-hypertensive medication and follow up with the nephrologist