Nephritis refers to inflammation in the nephrons of the kidneys. It causes:
- Reduced kidney function
- Haematuria (blood in the urine)
- Proteinuria (protein in the urine)
The two most common causes of nephritis in children are:
- Post-streptococcal glomerulonephritis
- IgA nephropathy (Berger’s disease)
Post-Streptococcal Glomerulonephritis
Post-streptococcal glomerulonephritis occurs 1-3 weeks following group A streptococcus (GAS) infection (e.g., tonsillitis caused by Streptococcus pyogenes).
Immune complexes made of streptococcal antigens, antibodies and complement proteins get stuck in the glomeruli, causing inflammation and leading to an acute drop in renal function (acute kidney injury).
The typical patient is aged 5-12, has a history of tonsillitis and presents with oedema, haematuria and high blood pressure.
Management is supportive. Most patients make a full recovery. Rarely, it can cause chronic kidney disease.
Complications, such as hypertension and oedema, may be treated with antihypertensives and diuretics.
IgA Nephropathy
IgA nephropathy, also known as Berger’s disease, involves immunoglobulin A deposits in the nephrons of the kidneys, causing inflammation (nephritis).
Histology shows IgA deposits and mesangial proliferation. The mesangial cells are found in the centre of the glomerulus and help support the capillaries (as well as performing other functions).
It usually presents in teenagers or young adults (15-35 years) with haematuria.
Management involves:
- Supportive treatment of the renal failure (e.g., antihypertensives and low sodium intake)
- Immunosuppressant medications (e.g., steroids) to slow the disease progression
Last updated March 2025
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