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Symptoms of acute glomerulonephritis
Last reviewed: 04.07.2025
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In typical cases, acute poststreptococcal glomerulonephritis manifests itself as nephritic syndrome, which is characterized by peripheral edema, arterial hypertension, urinary syndrome in the form of microhematuria and moderate proteinuria (up to 1 g/day). Macrohematuria is observed in 25-50% of cases.
A clinical blood test reveals an increase in ESR, moderate leukocytosis, and mild anemia. An increased titer of antistreptolysin O (ASLO) in the blood is noted in 50-80% of patients. A characteristic sign of acute poststreptococcal glomerulonephritis is a decrease in the concentration of the C3 component of the complement system in the blood with a normal concentration of the C4 component, which is observed in 90% of patients in the first 2 weeks from the onset of the disease. Nephrotic syndrome develops rarely (2-5%). It is manifested by widespread edema, severe proteinuria (>3 g/day), hypoalbuminemia, and hyperlipidemia. In 50-70% of patients, renal function is impaired - oliguria develops (diuresis <1 ml/kg per hour in children under one year or <0.5 ml/kg per hour in older children). ARF in children with acute post-streptococcal GN is rare (1-5% of patients).
The clinical course of acute glomerulonephritis in most cases is characterized by reversible and consistent resolution of the manifestations of glomerulonephritis and restoration of renal function.
The acute stage of the disease usually lasts 5-7 days, but can last more than 3 weeks. Macrohematuria and edema syndrome disappear 1-2 weeks after the onset of the disease, blood pressure normalizes and kidney function is restored after 2-4 weeks. After 3-6 months from the onset of the disease, the concentration of the C3 component of the complement system in the blood of the vast majority of patients is normalized, proteinuria and hematuria are absent. After a year, hematuria persists in only 2% of children, proteinuria - in 1%.
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