Acute

Glomerulonephritis

Adlyanna Velasco
 Definition
 Acute glomerulonephritis is the inflammation
of the glomeruli which causes the kidneys to
malfunction
• It is also called Acute Nephritis,
Glomerulonephritis and Post-Streptococcal
Glomerulonephritis
• Predominantly affects children from ages 2 to
12
• Incubation period is 2 to 3 weeks
 Causative Agent
• Streptococcus pyogenes
 Virulence factor
• The virulence factor is partly due to the substantial array
of surface antigens, toxins and enzymes it can generate.
• Specialized polysaccharides on the surface of the cell wall
help to protect the bacterium from being dissolved by the
lysozyme of the host.
• Lipoteichoic acid (LTA) contributes to the adherence of
the S. pyogenes to epithelial cells in the pharynx.
• A spiky surface projection called M protein contributes to
virulence by resisting phagocytosis and possibly
contributes to its adherence.
 Virulence factor
• A capsule made of hyaluronic acid is formed by most
S. pyogenes strains contributes to the bacterium’s
adhesiveness and because it is chemically
indistinguishable from the HA found in humans it
does not provoke an immune response from the host
• Extracellular toxins called streptolysins (O &
S)rapidly injure many cels and tissues
 Transmission
• Respiratory droplets or direct contact with
mucus secretions; transmission via fomites is
possible but less common
 Culture/Diagnosis
• cultivation on sheep blood agar plates
• bacitracin disc test
• urine dipstick test
• CBC
• kidney biopsy
 Signs and Symptoms
• Hematuria: dark brown or smoky urine
• Oliguria: urine output is < 400 ml/day
• Edema: starts in the eye lids and face then the
lower and upper limbs then becomes
generalized; may be migratory
• Hypertension: usually mild to moderate
 General Symptoms
• Fever
• Headache
• Malaise
• Anorexia
• Nausea and vomiting
• High blood pressure
• Pallor due to edema and/or anemia
• Confusion
• Lethargy
• Loss of muscle tissue
• Enlargement of the liver
 Complications
• Hypertensive encephalopathy, heart failure
and acute pulmonary edema may occur in
severe cases
• Acute renal necrosis due to injury of capillary
or capillary thrombosis
 Prevention
• proper hygiene
• prompt medical assessment for necessary antibiotic
therapy should be sought when infection is suspected
• prophylactic immunizations
 Treatment
• Penicillin/Cephalexin
 Nursing Interventions
Independent:
• Bedrest helps in maintaining adequate blood flow to the
kidney.
• In order to rest the kidney during the acute phase, decreased
sodium and protein intake may be recommended.
• Fluid restrictions are adjusted according to the patient's
urinary output and body weight.
• An accurate daily record of the patient's weight, fluid intake
and urinary output assist in estimating kidney function.
 Nursing Interventions
Dependent:
• If residual infection is suspected, antibiotic therapy
may be needed.
• In the presence of fluid overload, diuretics may be
used to increase output with urination.
• Iron and vitamin supplements may be ordered if
anemia develops
• antihypertensives, if high blood pressure accompanies
the illness.