What Is Post-Streptococcal Glomerulonephritis?

Post-streptococcal glomerulonephritis is a kidney disorder that a patient may experience after infection with some species of Streptococcus. This condition is unusual in regions where antibiotics are promptly administered for Streptococcus infections, also known colloquially simply as “strep.” Many patients make a full recovery, while others may develop renal insufficiency, where the kidneys fail to perform effectively and cause health problems like congestive heart failure.

The exact mechanism that causes post-streptococcal glomerulonephritis is not fully understood. Research suggests it may be the result of an acute immune reaction. This reaction causes the small blood vessels in the kidneys to inflame and will make the kidneys less efficient. One consequence of poor kidney function is the presence of unusual compounds in the urine. Patients have large numbers of white blood cells in their urine and can also develop visibly bloody urine with lots of red blood cells.

Patients with post-streptococcal glomerulonephritis may not experience any obvious symptoms. Fatigue may be attributed to the recent infection, and the mild swelling seen in the early stages of kidney irritation may not be immediately noticeable. Often the urine appears normal on a casual examination, and the patient's urine may not be tested unless it appears bloody or the patient experiences painful urination.

Treatment for post-streptococcal glomerulonephritis requires providing supportive care to reduce the inflammation in the kidneys. Pediatric patients often rebound very well and may return to normal kidney function soon. In adults, this condition can lead to congestive heart failure and may cause severe complications. It is important to monitor patients with a history of strep for signs of post-streptococcal glomerulonephritis. A patient who notices urine changes, feels sluggish, or develops edema, where liquid pools in the extremities and causes swelling, should consult a doctor for treatment and advice.

If post-streptococcal glomerulonephritis leads to complications like congestive heart failure, the patient may need hospitalization. In a hospital, nurses and doctors can provide more aggressive interventions in addition to monitoring the patient very closely.

The best way to treat post-streptococcal glomerulonephritis is to prevent it with prompt and appropriate treatment for infections. A doctor can prescribe antibiotics to kill the bacteria and prevent systemic inflammation. This will protect the kidneys and limit the chances of complications. In cases where a patient appears to have a drug-resistant infection, it may be necessary to order cultures to determine antibiotic susceptibility and prescribe the most appropriate drug for the patient.