Which medications are used in 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

The need for medicines in acute poststreptococcal glomerulonephritis (ASPGN) is usually limited in scope and in length. Administer antibiotics (penicillin or erythromycin) for 10 days to ensure eradication of the streptococcus if the disease is believed to be acute poststreptococcal glomerulonephritis and if risk of contamination is present. Some clinicians use this treatment only when evidence suggests an active infection.

Antihypertensives are usually not necessary after the child leaves the hospital, although mild hypertension may persist for as many as 6 weeks. The medications that can be used span the entire range of antihypertensives, such as vasodilators (eg, hydralazine), calcium channel-blocking agents (eg, amlodipine), or angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril).

Carefully monitor blood pressure (BP) for at least 1 week after the drug is discontinued to ensure that rebound hypertension does not occur.

Diuretic agents (eg, furosemide) are rarely needed in the long term; hypertension persisting beyond the first week may suggest a diagnosis other than acute glomerulonephritis.


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