The Indian Journal of Pediatrics

, Volume 69, Issue 12, pp 1071–1075 | Cite as

Acute and crescentic glomerulonephritis

  • M. VijayakumarEmail author
Symposium on Nephrology-I


Acute nephritic syndrome is clinically characterized by hematuria, proteinuria, oliguria, and volume overload with or without azotemia and histologically be acute proliferative glomerulonephritis. Acute post streptococcal glomerulonephritis is the commonest cause in children. There is a preceding infection prior to this condition in majority. This is one of the comonest causes of renal edema in children. Early recognition, prompt and aggressive therapy and adequate follow-up are mandatory. Prognosis is usually good unless associated with severe renal failure and crescentic glomerulonephritis where the outcome is relatively poor unless treatment is early and adequate. Pathologically acute proliferative nephritis is with diffuse proliferative glomerulonephritis with or without crescents. Immunosuppressive therapy is not needed in simple acute proliferative glomerulonephritis but is essential in modifying the outcome of crescentic glomerulonephritis. Delayed resolution, severe renal failure at onset, progressive renal failure and associated systemic features like skin rashes, joint pains, hepatosplenomegaly and persistent fever are the indications for biopsy. Overall the prognosis in classical post streptococcal acute proliferative glomerulonephritis is good.

Key words

Acute nephritic syndrome Acute proliferative glomerulonephritis Biopsy Crescentic glomerulonephritis 


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  1. 1.
    Camerson JS. The natural history of glomerulonephritis. In Black DAK, ed. Renal Disease, 4th edn. Oxford, Blackwell, 1979; 329–399.Google Scholar
  2. 2.
    Cole BR, Madrigal LS. Acute proliferative glomerulonephritis and crescentic glomerulonephritis. In Barrat TM, Avner Ed, Harmon WE, eds. Pediatric Nephrology, 4th edn. Philadeplphia, Lippincott, 1999; 669–689.Google Scholar
  3. 3.
    Nammalwar BR, Vasanthi, T. Acute glomerulonephritis. In Parthasathy A, ed.IAP Text Book of Pediatrics, 2nd edn. Jaypee Brothers, New Delhi, 2002; 468–469.Google Scholar
  4. 4.
    Nissenson AR, Baraff, LJ, Fine RN et al. Post-streptococcal acute glomerulonephritis; fact and controversy.Ann Intern Med 1979; 91: 76–86.PubMedGoogle Scholar
  5. 5.
    Said R, Hussein M, Hassan A. Simultaneous occurrence of acute poststreptococcal glomerulonephritis and acute rheumatic fever.Am J Nephrol 1986; 6:146–148.PubMedCrossRefGoogle Scholar
  6. 6.
    Smith MC, Cooke JH, Zimmerman DMet al. Asymptomatic glomerulonephritis after non-streptococcal upper respiratory infections.Ann Intern Med 1979; 91: 697–702.PubMedGoogle Scholar
  7. 7.
    Couser WG. Rapidly progressive glomerulonephritis; classification, pathogentic mechanisms and therpy.Am J Kidney Dis 1988; 11:449–464.PubMedGoogle Scholar
  8. 8.
    Pusey CD, Venning MC, Peters DK. Immunopathology of glomerular and interstitial disease. In Schrier RW, Gottschalk DW, eds.Disease of the Kidney, 4th edn. Boston, Little Brown, 1988; 1827–1883.Google Scholar
  9. 9.
    Wilson CB. Antibody reactions with native or planted glomerular antigens producing nephritogenic immune deposits or selective glomercular cell injury. In Wilson CB, Brenner BM, Steth, JH, eds.Immunopathology of Renal Disease. New York, Churchill Livingstone, 1988; 1–34.Google Scholar
  10. 10.
    Luthar TMD. Acute poststreptococcal glomerulonephritis. CME on acute glomerukmephritise, Medicine com. inc, 2002, 1–27.Google Scholar
  11. 11.
    Srivastava RN, Bagga A. Acute glomerulonephritis. InPediatric Nephrology, 3rd edn. New Delhi, Jaypee Brothers, 2001; 88–100.Google Scholar
  12. 12.
    Vijaykumar M. Acute nephritic syndrome. In Nammalwar BR, Vijayakumar M, eds.Pediatric Nephrology, 2nd edn. Chennai, 1991; 90–98.Google Scholar
  13. 13.
    Vijayakumar M, Nammalwar BR. Diagnostic approach to a child with hematuria.Indian Pediatr 1998; 35:525–532.PubMedGoogle Scholar
  14. 14.
    Couser WG. Idiopathic rapidly progressive glomerulo-nephritis.Am J Nephrol 1982; 2:57–69.PubMedCrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2002

Authors and Affiliations

  1. 1.Kanchi Kamakoti Childs Trust HospitalTamil Nadu

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