D.G.
Post-streptococcal GN
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Kidney anatomy Definition
Post-streptococcal GN is a disorder of the kidneys that occurs after infection with certain strains of Streptococcus bacteria.
Alternative Names
Glomerulonephritis - post-streptococcal; Post-infectious glomerulonephritis
Causes, incidence, and risk factors
Post-streptococcal GN is a form of glomerulonephritis. It is the result of an infection, not of the kidneys, but of a completely different area, such as the skin or throat, with a specific type of Group A hemolytic streptococcus bacteria.
The infection causes the tiny blood vessels called glomeruli in the kidneys to become inflamed, making the kidneys less able to filter and remove wastes.
Post-streptococcal glomerulonephritis is uncommon these days because infections that can lead to the disorder are commonly treated with antibiotics. The disorder may develop 1 - 2 weeks after an untreated throat infection, or 3 - 4 weeks after a skin infection.
It may occur in people of any age, but most often occurs in children ages 6 - 10. Although skin and throat infections are not uncommon in children, post-streptococcal glomerulonephritis is a rare complication of these infections.
Risk factors include:
Sore throat
Strep throat
Streptococcal skin infections (such as impetigo)
Symptoms
Cough, with sputum
Decreased urine output
Edema (swelling)
Generalized swelling
Swelling of the abdomen
Swelling of the face or eyes
Swelling of the feet, ankles, extremities
Smoky urine
Rust-colored urine
Visible blood in the urine
Other symptoms that may be associated with this disease:
Joint pain
Joint stiffness
Signs and tests
Abnormal sounds are heard when listening to the heart and lungs with a stethoscope (auscultation)
Anti-DNase B test may be abnormal
Blood pressure is often high
Examination shows swelling (edema), especially of the face
Kidney biopsy confirms post-streptococcal glomerulonephritis (although biopsy is not usually necessary)
Serum ASO may be raised
Serum complement levels usually decrease
Urinalysis shows protein and blood in the urine
Treatment
There is no specific treatment for post-streptococcal glomerulonephritis. Treatment is focused on relieving symptoms.
Antibiotics, such as penicillin, should be used to destroy any streptococcal bacteria that remain in the body. Blood pressure medications and diuretic medications may be needed to control swelling and high blood pressure. Corticosteroids and other anti-inflammatory medications are generally not effective.
Dietary salt restriction may be necessary to control swelling and high blood pressure.
Expectations (prognosis)
Post-streptococcal glomerulonephritis usually goes away by itself after several weeks to months. In a minority of adults, it may progress to chronic kidney failure.
Complications
Acute renal failure
Chronic glomerulonephritis
Chronic renal failure
Congestive heart failure or pulmonary edema
End-stage renal disease
Hyperkalemia
High blood pressure (hypertension)
Nephrotic syndrome
Calling your health care provider
Call your health care provider if you have symptoms of post-streptococcal GN.
If you have experienced post-streptococcal GN, call your health care provider if you have decreased urine output or other new symptoms.
Prevention
Treating known streptococcal infections may prevent post-streptococcal GN.
References
Brenner BM. Brenner and Rector's The Kidney. 7th ed. Philadelphia, Pa: Saunders; 2003.
Review Date: 11/12/2007
Reviewed by: Charles Silberberg, D.O., Private Practice specializing in Nephrology, Affiliated with NY Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.
