Post-Streptococcal Glomerulonephritis

What is post-streptococcal glomerulonephritis?

Post-streptococcal glomerulonephritis is a disease of the kidneys which occurs after infection with a bacteria called Streptococcus. Streptococcal bacteria most commonly cause infections of the tonsils and skin. This condition tends to affect children between the ages of 5 and 12 and adults older than 60. The symptoms are swelling of the legs, hands and face and blood in the urine. Most people also develop high blood pressure. Often there is no specific treatment for this condition, but the infection should be treated and measures may be needed to support the kidneys while they recover. Children usually recover very well from this condition within 6 to 8 weeks. Adults are more likely to develop complications, including high blood pressure and kidney damage.

Risks

The kidneys are two organs that sit underneath the ribs in the back and which are responsible for filtering toxins from the blood and maintaining the balance of fluid and electrolytes. If the small filtration units of the kidney (the glomeruli) become inflamed and swollen, this is called glomerulonephritis. There are several possible causes, including autoimmune conditions (when the immune system begins to mistakenly attack the healthy body tissues), following an infection, and some medical conditions, including diabetes and some cancers. Glomerulonephritis following an infection with the Streptococcus bacteria is one of the most common causes of kidney disease in children worldwide, although it is uncommon in countries with good access to health care. The Streptococcus most commonly causes tonsillitis and skin infections. It is thought that this causes glomerulonephritis because the immune system mistakes the kidney cells for the Streptococcal bacteria. This condition is most common in children between the ages of 5 and 12 years and adults older than 60. It tends to affects males and females equally.

Symptoms

The symptoms of this condition may vary in severity from person to person. The most common symptoms are red or brown urine and swelling of the feet and legs. People with this condition also develop high blood pressure, but this usually has no symptoms. These symptoms may be accompanied by other complaints such as flank (side) pain, a feeling of weakness, and passing only small amounts of urine. Some people may become short of breath or develop a cough. Symptoms start within 3 weeks after a bacterial infection.

Diagnosis

The diagnosis may be suspected based on the symptoms and physical examination in a person who has recently been unwell with a bacterial infection. Blood and urine tests help to confirm the diagnosis, and are necessary for monitoring the kidney function and recovery. An ultrasound of the kidneys is often performed as well. If the diagnosis is uncertain, a small sample of the kidney may need to be taken (a biopsy) and investigated for the cause of the kidney problems.

Treatment

Treatment of post-streptococcal glomerulonephritis usually involves treating the bacterial infection (if necessary), monitoring and supporting kidney function and treating the symptoms. There is no specific treatment for this condition. Management may involve using diuretic medications to reduce the amount of fluid in the body, and medications to reduce blood pressure. If severe kidney damage has occurred, dialysis may be needed to support the person while the kidneys recover.

Prevention

Diagnosis and treatment of bacterial tonsillitis can help prevent some people from developing post-streptococcal glomerulonephritis.

Other names for post-streptococcal Gglomerulonephritis

  • poststreptococcal glomerulonephritis
  • postinfectious glomerulonephritis