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Post Streptococcal Glomerulonephritis conforms to the typical presentation of a type III hypersensitivity reaction in that antigen-antibody complexes are deposited in the glomeruli of the kidneys causing inflammation, pain, swelling and fever. In addition, blood serum levels of patients with the condition show aggressive activation of the complement system, another hallmark of a type III hypersensitivity.

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Type III hypersensitivity (immune complex mediated) - causes, symptoms & pathology

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Acute Glomerulonephritis Nursing (Poststreptococcal) | Nephritic Syndrome NCLEX Review

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*Recent bacterial infection (Group A strep infection of throat or skin)
*Age 5-12 are most susceptible
*Uninsured individuals who are not as likely to seek treatment for initial strep infection.

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HAD STREP acronym to remember clinical signs and symptoms

H-hypertension (due to renal impairment)
A-anti streptolysin titer (will be positive)
D-decreased GFR (low urine output)
S-swelling (face & eyes, mostly in morning)
T-tea or cola colored urine (hematuria)
R-recent strep infection
E-elevated BUN/creatinine (low urine flow)
P- proteinuria (inflammation in kidneys)

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The underlying pathophysiologic mechanism for poststreptococcal glomerulonephritis is inflammation causing tissue destruction. Nephritis associated plasmin receptors bind to glomeruli and damage the basement membrane. These receptors are produced as an immune response following a streptococcal infection.

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-Management of swelling and hypertension
*Low sodium/potassium diet
*Restricted fluid intake
*Increased calcium in diet (prevents      kidney stone formation)
*Decrease protein intake
*Use of diuretic medication

-Treatment of lingering streptococcal infection
*Penicillin

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Additional Background Information from the CDC

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Additional Background Information from the CDC

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Post-streptococcal glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) - or PSGN - is a rare kidney disease that can develop after group A strep infections.

The main way to prevent PSGN is to prevent group A strep infections.

PSGN is an inflammatory disease

PSGN is a kidney disease that is thought to be an immune response to an earlier infection.

As the body's defense system, the immune system is important in fighting off infections. But the immune system can mistakenly attack healthy parts of the body and cause damage.

How you get PSGN

PSGN can develop after infections caused by bacteria called group A Streptococcus (group A strep). These infections include:

PSGN is not a group A strep infection of the kidneys. Instead PSGN results from the body's immune system fighting off strep throat, scarlet fever, or impetigo.

After the start of strep throat or scarlet fever symptoms, it usually takes about 10 days for PSGN to develop. After the start of impetigo symptoms, it takes about 3 weeks for PSGN to develop.

PSGN is not contagious

People cannot catch PSGN from someone else because it is an immune response and not an infection. However, people with a group A strep infection can spread the bacteria to others.

Symptoms usually point to kidney issues

Symptoms of PSGN can include:

Dark, reddish-brown urine

Edema (swelling), especially in the face, around the eyes, and in the hands and feet

Decreased need to pee or decreased amount of urine

Fatigue due to mild anemia (feeling tired due to low iron levels in the blood)

In addition, someone with PSGN usually has:

Protein in the urine

Hypertension (high blood pressure)

Some people may have no symptoms or symptoms that are so mild that they don't seek medical help.

Some people are at increased risk

Anyone can get PSGN after having strep throat, scarlet fever, or impetigo. People at increased risk for those infections are also at increased risk for getting PSGN.

Age

PSGN is more common in children than adults.

Developing PSGN after strep throat or scarlet fever is most common in young, school-age children.

Developing PSGN after impetigo is most common in preschool-age children.

Doctors look at how well the kidneys are working

Doctors diagnose PSGN by looking at a patient's medical history and ordering lab tests. Doctors can test urine samples to look for protein and blood. Doctors can also do a blood test to see how well the kidneys are working. They can also determine if a patient recently had a group A strep infection.

Treatment focuses on managing swelling, blood pressure

Treatment of PSGN focuses on managing symptoms as needed:

Decreasing swelling by limiting salt and water intake or by prescribing a diuretic (medication that increases the flow of urine)

Managing high blood pressure through blood pressure medication

Treatment may include antibiotics

People with PSGN who still have group A strep bacteria in their throat are often provided antibiotics.

When to return to work, school after illness

People with strep throat or scarlet fever should stay home from work, school, or daycare until they:

AND

Have taken antibiotics for at least 12 to 24 hours; ask the doctor how long you should stay home after starting antibiotics

Antibiotic dos and don'ts

1. Do take the prescription exactly as the doctor says to.

2. Don't stop taking the medicine, even if you or your child feels better, unless the doctor says to stop.

You can find more guidance on taking antibiotics on CDC's Antibiotic Do's & Don'ts Page.

Serious complications include long-term kidney damage

Most people who develop PSGN recover within a few weeks without any complications. While rare, long-term kidney damage, including kidney failure, can occur. These rare complications are more common in adults than children.

Protect yourself and others

The main way to prevent PSGN is to prevent group A strep infections like strep throat, scarlet fever, and impetigo. Getting a group A strep infection does not protect someone from getting it again in the future. There are no vaccines to prevent group A strep. However, there are things people can do to protect themselves and others.

Good hygiene

The best way to keep from getting or spreading group A strep bacteria is to wash your hands often. This is especially important after coughing or sneezing and before preparing foods or eating.

To prevent group A strep infections, you should:

Cover your mouth and nose with a tissue when you cough or sneeze.

Put your used tissue in the waste basket.

Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue.

Wash your hands often with soap and water for at least 20 seconds.

Use an alcohol-based hand rub if soap and water are not available.

You should also wash glasses, utensils, and plates after someone who is sick uses them. These items are safe for others to use once washed.

Antibiotics

Antibiotics help prevent someone with a group A strep infection from spreading the bacteria to others.

Related diseases

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Post-Streptococcal Glomerulonephritis: All You Need to Know

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Post-streptococcal glomerulonephritis is a rare kidney disease that can occur after bacterial infections like strep throat, scarlet fever, or impetigo.