Post-Streptococcal Glomerulonephritis

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Rx Urology

Post-streptococcal glomerulonephritis (PSGN) is a kidney condition that occurs after an infection caused by certain strains of streptococcus bacteria, commonly known for causing strep throat or skin infections. In PSGN, the immune system’s response to the infection leads to inflammation in the glomeruli, the tiny filters in the kidneys, which can affect kidney function.

Pathophysiology

1. Structure of the Kidneys:

  • The kidneys are two bean-shaped organs located on either side of the spine, just above the waist. They filter waste from the blood and regulate fluid and electrolytes.

2. Blood Supply:

  • Each kidney has a rich blood supply. The renal artery brings oxygen-rich blood to the kidneys, while the renal vein carries filtered blood away.

3. Nerve Supply:

  • The kidneys are innervated by the autonomic nervous system, which helps regulate functions like blood flow and filtration.

4. Glomeruli Function:

  • The glomeruli are the filtration units of the kidneys, where blood is cleaned. In PSGN, these structures become inflamed due to immune responses to the streptococcus bacteria.

Types of Post-Streptococcal Glomerulonephritis

  1. Acute PSGN: Develops suddenly, often after a streptococcal infection.
  2. Chronic PSGN: A long-lasting condition that can develop after repeated infections or untreated cases.
  3. Rapidly Progressive Glomerulonephritis: A severe form that progresses quickly and can lead to kidney failure.

Causes of Post-Streptococcal Glomerulonephritis

  1. Streptococcal Infections: Most commonly after strep throat or skin infections.
  2. Impetigo: A bacterial skin infection caused by strep or staph bacteria.
  3. Scarlet Fever: A strep infection characterized by a red rash.
  4. Endocarditis: Infection of the heart lining that can also trigger PSGN.
  5. Strep Pneumonia: A type of pneumonia caused by streptococcus.
  6. Chronic Skin Conditions: Such as eczema that may lead to skin infections.
  7. Weakened Immune System: Infections can occur more easily.
  8. Poor Hygiene: Increases the risk of streptococcal infections.
  9. Other Infections: Such as those from the respiratory system.
  10. Genetic Factors: Family history may increase susceptibility.
  11. Environmental Factors: Poor living conditions that promote infections.
  12. Age: More common in children but can affect adults.
  13. Certain Chronic Diseases: Like diabetes or autoimmune conditions.
  14. Direct Trauma to Skin: Leading to infections.
  15. Living in Crowded Conditions: Like schools or military barracks.
  16. Unhygienic Practices: Such as sharing personal items.
  17. Overcrowded Living Situations: Increases transmission of infections.
  18. Seasonal Variations: Higher rates in colder months.
  19. Close Contact Sports: Can lead to skin infections.
  20. Underlying Kidney Disease: Makes one more susceptible.

Symptoms of Post-Streptococcal Glomerulonephritis

  1. Swelling: Especially in the face and eyes.
  2. High Blood Pressure: Increased pressure in the vessels.
  3. Dark Urine: Due to blood in the urine (hematuria).
  4. Foamy Urine: Indicating protein in the urine (proteinuria).
  5. Fatigue: General tiredness and weakness.
  6. Shortness of Breath: Difficulty breathing due to fluid buildup.
  7. Nausea and Vomiting: Discomfort in the stomach.
  8. Loss of Appetite: Not feeling like eating.
  9. Headaches: Due to high blood pressure.
  10. Puffiness: Swelling of the abdomen or limbs.
  11. Back Pain: Pain near the kidneys.
  12. Decreased Urination: Urinating less than normal.
  13. Joint Pain: Generalized discomfort in the joints.
  14. Fever: Occasionally due to infection.
  15. Confusion: Especially in severe cases.
  16. Skin Rash: Often from the original infection.
  17. Itching: Caused by toxins accumulating in the body.
  18. Anemia: Fatigue from low red blood cells.
  19. Changes in Skin Color: Due to circulation issues.
  20. Sensitivity to Light: Discomfort in bright light.

Diagnostic Tests for Post-Streptococcal Glomerulonephritis

  1. Urinalysis: Checks for blood and protein in urine.
  2. Blood Tests: Measures kidney function (creatinine and urea).
  3. Streptococcal Antigen Test: Identifies recent strep infection.
  4. Throat Culture: Confirms strep throat diagnosis.
  5. Antibody Tests: Checks for antibodies against streptococcus.
  6. Renal Ultrasound: Visualizes kidney structure.
  7. Kidney Biopsy: Samples kidney tissue for analysis.
  8. 24-Hour Urine Collection: Measures kidney waste over a day.
  9. CT Scan: Provides detailed images of kidneys.
  10. Electrolyte Levels: Checks for imbalances in the blood.
  11. Blood Pressure Monitoring: Assesses hypertension.
  12. C-reactive Protein Test: Measures inflammation in the body.
  13. Complement Levels: Checks immune system components.
  14. Immunological Tests: Looks for immune system abnormalities.
  15. Liver Function Tests: Assesses overall health and liver function.
  16. Echocardiogram: Checks heart function due to high blood pressure.
  17. Chest X-ray: To look for fluid buildup.
  18. Urine Microscopy: Looks for cells and crystals in urine.
  19. Glomerular Filtration Rate (GFR): Evaluates kidney function.
  20. Pregnancy Test: In females, to rule out pregnancy-related complications.

Non-Pharmacological Treatments for Post-Streptococcal Glomerulonephritis

  1. Dietary Changes: Low-sodium diet to reduce blood pressure.
  2. Increased Hydration: Drinking plenty of fluids.
  3. Rest: Ensuring adequate sleep and relaxation.
  4. Weight Management: Maintaining a healthy weight.
  5. Monitoring Blood Pressure: Regular checks at home.
  6. Limit Protein Intake: Reducing strain on kidneys.
  7. Reduce Stress: Engaging in stress-relief activities.
  8. Regular Check-ups: Monitoring kidney health with a doctor.
  9. Physical Therapy: If swelling limits mobility.
  10. Education: Understanding the condition and its management.
  11. Avoiding Strenuous Exercise: To prevent additional stress on kidneys.
  12. Home Remedies: Natural diuretics like dandelion tea.
  13. Support Groups: Connecting with others for emotional support.
  14. Using Cold Compresses: To reduce swelling.
  15. Good Hygiene Practices: Preventing further infections.
  16. Avoiding Alcohol: To protect kidney function.
  17. Smoking Cessation: To improve overall health.
  18. Mindfulness and Meditation: For mental well-being.
  19. Yoga and Gentle Stretching: To enhance circulation.
  20. Herbal Supplements: Under professional guidance.
  21. Family Education: Teaching family members about the condition.
  22. Avoiding Processed Foods: Reducing sodium intake.
  23. Regular Blood Tests: To monitor kidney function.
  24. Encouraging Light Exercise: Walking or stretching as tolerated.
  25. Limiting Sugar Intake: To manage overall health.
  26. Maintaining a Healthy Gut: Probiotics to support digestive health.
  27. Hydrotherapy: Using water for relief and relaxation.
  28. Mind-Body Techniques: Such as yoga for stress relief.
  29. Utilizing Heat Packs: For discomfort and pain relief.
  30. Routine Screenings: For those at high risk.

Medications for Post-Streptococcal Glomerulonephritis

  1. Antibiotics: To treat underlying infections (e.g., penicillin).
  2. Diuretics: Help reduce swelling and high blood pressure.
  3. Corticosteroids: Reduce inflammation in severe cases.
  4. Angiotensin-Converting Enzyme (ACE) Inhibitors: Lower blood pressure.
  5. Angiotensin II Receptor Blockers (ARBs): Help manage blood pressure.
  6. Immunosuppressants: For severe immune response.
  7. Calcium Channel Blockers: Manage high blood pressure.
  8. Statins: Lower cholesterol levels if elevated.
  9. Antihypertensives: General blood pressure management.
  10. Renin Inhibitors: Help lower blood pressure.
  11. Pain Relievers: Such as acetaminophen for discomfort.
  12. Antihistamines: For allergy symptoms.
  13. Anticoagulants: In cases of blood clot risk.
  14. Potassium Binders: To manage high potassium levels.
  15. Phosphate Binders: To control phosphate levels.
  16. Bicarbonate Supplements: For acidosis management.
  17. Vitamin D Supplements: To support bone health.
  18. Nutritional Supplements: To support overall health.
  19. Topical Steroids: For skin rashes associated with infections.
  20. Laxatives: To manage constipation from medications.

Surgical Interventions for Post-Streptococcal Glomerulonephritis

  1. Kidney Biopsy: To diagnose the extent of damage.
  2. Dialysis: In severe cases where kidneys fail to function.
  3. Renal Artery Angioplasty: To open blocked arteries.
  4. Nephrectomy: Removal of a damaged kidney if necessary.
  5. Placement of Catheters: For dialysis access.
  6. Shunt Placement: For fluid management in severe cases.
  7. Urinary Diversion: In cases of severe urinary tract issues.
  8. Ureteral Stenting: To relieve obstruction.
  9. Surgical Repair of Obstructions: In urinary tract.
  10. Kidney Transplantation: For patients with end-stage kidney disease.

Prevention of Post-Streptococcal Glomerulonephritis

  1. Good Hygiene Practices: Handwashing to prevent infections.
  2. Prompt Treatment of Strep Infections: Early intervention with antibiotics.
  3. Avoiding Close Contact: With those infected with strep bacteria.
  4. Regular Health Check-ups: Monitoring for risk factors.
  5. Vaccinations: Staying up to date on necessary vaccines.
  6. Managing Chronic Conditions: Such as diabetes or hypertension.
  7. Healthy Diet: Eating a balanced diet to strengthen the immune system.
  8. Staying Hydrated: Drinking plenty of fluids daily.
  9. Avoiding Skin Injuries: Protecting skin from cuts and scrapes.
  10. Educating About Infections: Awareness of signs and symptoms.

When to See a Doctor

  • If experiencing symptoms of strep throat (sore throat, fever).
  • Noticeable swelling, especially in the face or limbs.
  • Changes in urine color or frequency.
  • Persistent headaches or high blood pressure.
  • Symptoms of a skin infection (redness, pus).
  • Any signs of fatigue or general malaise.
  • If previously diagnosed with kidney disease and symptoms worsen.

Frequently Asked Questions (FAQs)

  1. What is PSGN?
    • It is a kidney condition that occurs after a streptococcal infection.
  2. Who is at risk for PSGN?
    • Mostly children, but adults can be affected, especially with weakened immune systems.
  3. What are the symptoms of PSGN?
    • Symptoms include swelling, dark urine, and high blood pressure.
  4. How is PSGN diagnosed?
    • Through blood tests, urinalysis, and sometimes kidney biopsies.
  5. Can PSGN be prevented?
    • Yes, by treating strep infections promptly and practicing good hygiene.
  6. What treatments are available?
    • Treatments range from medications to manage symptoms and inflammation to dietary changes.
  7. Is surgery ever needed?
    • Surgery is rare and usually only if there are severe complications.
  8. How long does PSGN last?
    • Acute cases often resolve within weeks to months, but chronic cases may persist.
  9. Can PSGN lead to kidney failure?
    • In severe cases, it can lead to kidney damage and failure.
  10. What lifestyle changes can help manage PSGN?
    • Eating a balanced diet, staying hydrated, and monitoring blood pressure are crucial.
  11. Are there long-term effects of PSGN?
    • Some patients may experience long-term kidney issues.
  12. How often should I see a doctor if I have PSGN?
    • Regular check-ups are important, especially in the first year after diagnosis.
  13. What role do antibiotics play in PSGN?
    • They are used to treat the initial streptococcal infection.
  14. Can PSGN occur after any infection?
    • It is specifically linked to certain strains of streptococcus.
  15. What should I do if I think I have PSGN?
    • Contact your healthcare provider for evaluation and testing.

This guide provides a comprehensive overview of post-streptococcal glomerulonephritis, aiming to educate and inform in a straightforward manner. Understanding this condition can help patients manage their health effectively and seek timely medical attention when necessary.

 

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Last Update: October 25, 2024.

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

 

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