What is the role of hematologic and blood chemistry studies in the workup of acute poststreptococcal glomerulonephritis (APSGN)?

Updated: Dec 05, 2018
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Erythropoiesis may decline in the aftermath of acute glomerulonephritis, particularly in individuals with severe cases.

A mild anemia (normocytic, normochromic) is common in persons in the early phase of acute glomerulonephritis; its degree tends to parallel the degree of extracellular fluid (ECF) volume expansion. White blood cell (WBC) and platelet counts are usually normal, although an occasional patient exhibits a leukocytosis; rarely, a mild thrombocytopenia may be present.

The extent of renal functional impairment is correlated directly to the severity of the glomerular injury. A few patients have hypoproteinemia and hyperlipidemia. A nephrotic picture has been reported in approximately 5% of hospitalized patients with poststreptococcal acute glomerulonephritis (APSGN).

The elevation in the serum concentrations of creatinine and blood urea nitrogen (BUN) is usually modest, although some patients may have severe azotemia at onset. The electrolyte profile is usually normal; hyperkalemia and metabolic acidosis are only present in patients with significant renal functional impairment. The same applies to hyperphosphatemia.

Total serum calcium, but not ionized calcium levels, may be low in patients who have a nephrotic picture.


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