What is the focus of the treatment 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

By the time the child with acute poststreptococcal glomerulonephritis (APSGN) presents with symptoms, the glomerular injury has already occurred, and the healing process has begun. Thus, influencing the ultimate course of the disease by any specific therapy directed at the cause of the nephritis is not possible. Conversely, morbidity and early mortality are influenced considerably by appropriate medical therapy. Even then, treatment is usually supportive and directed toward the potential complications.

Only a small percentage of patients with acute glomerulonephritis require initial hospitalization, and most of those are ready for discharge in 2-4 days. As soon as the blood pressure (BP) is under relatively good control and diuresis has begun, most children can be discharged and monitored as outpatients.

If indicated at any time during the course of the disease, an experienced nephrologist should perform renal biopsy percutaneously.

Transfer of responsibility for the patient with acute glomerulonephritis is rarely indicated, except in those instances in which a consultation with a nephrologist is not easily obtainable in the local area or by telephone, facsimile, or e-mail.

See Consultations for instances that necessitate consultation with a pediatric nephrologist.

See also Acute Glomerulonephritis and Emergent Management of Acute Glomerulonephritis.


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