Glomerulonephritis refers to inflammatory disorders of the glomeruli in the kidneys that are often caused by an immunological reaction. It results in proliferative and inflammatory changes within the glomerular structure that can lead to destruction, inflammation, and scarring of the glomeruli. The inflammation occurs via an antigen-antibody reaction triggered by an infection elsewhere in the body. Symptoms include edema, decreased urine output, blood in the urine, and hypertension. Diagnosis involves medical history, physical exam, urine and blood tests. Treatment focuses on monitoring vital signs, limiting activity, managing diet and fluid intake, and administering medications like diuretics, antihypertensives, and antibiotics. Comp

1. JOHNY WILBERT, M.Sc[N]
LECTURER,
APOLLO INSTITUTE OF HOSPITAL
MANAGEMENT AND ALLIED SCIENCE

2. Definition
Glomerulonephritis refers to a group of kidney
disorders characterized by inflammatory injury
in the glomerulus, most of which are caused by
an immunological reaction.

3.  The disorder results in proliferative and inflammatory
changes within the glomerular structure.
 Destruction, inflammation, and sclerosis of the
glomeruli of the kidneys occur.
 Inflammation of the glomeruli results from an
antigen-antibody reaction produced by an infection
elsewhere in the body.
 Loss of kidney function develops

4. Causes
1. Immunological diseases
2. Autoimmune diseases
3. Antecedent group A beta-hemolytic streptococcal
infection of the pharynx or skin
4. History of pharyngitis or tonsillitis 2 to 3 weeks before
symptoms

5. Types of Glomerulonephritis
 Acute Occurs 2 to 3 weeks after a streptococcal infection
 Chronic Can occur after the acute phase or slowly over
time

6. Clinical manifestation
1. Periorbital and facial edema that is more prominent in the
morning
2. Anorexia
3. Decreased urinary output
4. Cloudy, smoky, brown-colored urine (hematuria)
5. Pallor, irritability, lethargy
6. In an older child: Headaches, abdominal or
flank pain, dysuria

7. 7. Hypertension
8. Proteinuria that produces a persistent and
excessive foam in the urine
9. Azotemia
10. Increased blood urea nitrogen and creatinine
levels
11. Increased antistreptolysin O titer (used to
diagnose disorders caused by streptococcal
infections)

8. Diagnostic evaluation
 History collection
 Physical examination
 Urine examination
 Blood tests investigating the cause, including
 FBC, inflammatory markers, and special tests
(including ASLO, ANCA, Anti-GBM, Complement
levels, Anti-nuclear antibodies)
 Biopsy of the kidney
 Renal ultrasonography is useful for prognostic purposes in
finding signs of CKD , which however may be caused by
many other diseases than glomerulonephritis.

9. Mananagement
1. Monitor vital signs, weight, intake and output,
and characteristics of urine.
2. Limit activity; provide safety measures.
3. Provide high-quality nutrient foods.
a. Restrictions depend on the stage and severity
of the disease, especially the extent of
the edema.

10. b. In uncomplicated cases, a regular diet is permitted, but
sodium is restricted to a “no
added salt to foods” diet.
c. Moderate sodium and fluid restriction is
prescribed for a child with hypertension or edema.
d. Foods high in potassium are restricted during
periods of oliguria.
e. Protein is restricted if the child has severe azotemia
resulting from prolonged oliguria.

11. 4. Monitor for complications (e.g., renal failure,
hypertensive encephalopathy, seizures, pulmonary edema,
heart failure).
5. Administer diuretics (if significant edema and
fluid overload are present), antihypertensives
(for hypertension), and antibiotics (to a child
with evidence of persistent streptococcal infections) as
prescribed.

12. 6. Initiate seizure precautions and administer
anticonvulsants as prescribed for seizures associated with
hypertensive encephalopathy.
7. Instruct parents to report signs of bloody urine, headache,
or edema.
8. Instruct parents that the child needs to obtain
appropriate adequate treatment for infections,
specifically for sore throats, upper respiratory
infections, and skin infections.

13. Complications
1. Renal failure
2. Hypertensive encephalopathy
3. Pulmonary edema
4. Heart failure