Glomerulonephritis

Glomerulonephritis is inflammation of the glomeruli, the tiny filtering units within the kidneys. It can occur suddenly (acute) or develop gradually over time (chronic), and can affect kidney function significantly if not identified and managed.

• Blood in the urine, which may appear cola-coloured or, less often, bright red
• Swelling, particularly of the face (especially around the eyes) and legs
• Reduced urine output
• High blood pressure
• Foamy urine if significant protein is being lost
• Fatigue, particularly with more advanced kidney involvement

• In children, acute glomerulonephritis often follows a bacterial skin or throat infection (post-streptococcal glomerulonephritis), occurring one to a few weeks after the initial infection.
• Can also result from autoimmune conditions, certain infections, or, in some cases, no specific cause is identified.
• Chronic glomerulonephritis can develop from various underlying kidney conditions over a longer period.

• Diagnosed through urine testing showing blood and protein, together with blood tests assessing kidney function.
• A history of a recent throat or skin infection supports a diagnosis of post-streptococcal glomerulonephritis in children.
• Further specialised testing, and sometimes a kidney biopsy at a specialist facility, may be used to identify the specific underlying cause, particularly for cases that are severe, atypical, or not improving as expected.

Post-streptococcal glomerulonephritis in children is often managed with supportive care — monitoring blood pressure, fluid balance, and kidney function, since most children recover well over several weeks.

Blood pressure control, using appropriate antihypertensive medicine if needed, is an important part of management given the risk of hypertension in this condition.

Fluid and salt intake may be restricted temporarily if there is significant swelling or high blood pressure.

More severe cases, cases with significantly reduced kidney function, or those due to other underlying causes are referred to a specialist for further evaluation and specific treatment, which may include immune-suppressing medicine depending on the cause.

Regular monitoring of kidney function and blood pressure continues during recovery, and longer-term follow-up is needed for some underlying causes.

• Seek prompt treatment for streptococcal throat and skin infections, which may help reduce the risk of post-streptococcal glomerulonephritis, though this is not entirely preventable.
• Seek medical assessment for blood in the urine, unusual swelling, or high blood pressure, particularly in a child following a recent infection.
• Attend follow-up appointments to monitor kidney function and blood pressure during recovery.