Acute Postinfectious Glomerulonephritis

Reference work entry


The term acute postinfectious glomerulonephritis includes a large group of glomerulonephritis that result from a variety of infectious agents. In this chapter we will deal only with the most common glomerulonephritis that result from bacterial infections. The term acute glomerulonephritis defines a pathological process that may be manifested clinically as an acute nephritic syndrome, nephrotic syndrome or rapidly progressive glomerulonephritis. Since post-streptococcal glomerulonephritis is the best known of the acute postinfectious glomerulonephritis and its most frequent clinical picture is the acute nephritic syndrome, the terms poststreptococcal glomerulonephritis, acute glomerulonephritis and acute nephritic syndrome are often, and incorrectly, used interchangeably.


Nephrotic Syndrome Lupus Nephritis Infective Endocarditis Streptococcal Infection Crescentic Glomerulonephritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Germuth FG. Comparative histologic and immunologic study in rabbits of induced hypersensitivity of the serum sickness type. J Exp Med 1953;97:257–282.PubMedCrossRefGoogle Scholar
  2. 2.
    Germuth FG, Senterfit LB, Dressman GR et al. Immune complex disease. V. The nature of circulating complexes associated with glomerular alterations in chronic BSA-rabbit system. Johns Hopkins Med J 1972;130:344–357.PubMedGoogle Scholar
  3. 3.
    Dixon FJ, Feldman JD, Vasquez JJ. Experimental glomerulonephritis: the pathogenesis of a laboratory model resembling the spectrum of human glomerulonephritis. J Exp Med 1961;113:899–920.PubMedCrossRefGoogle Scholar
  4. 4.
    Vogt A, Schmiedeke T, Stockl F et al. The role of cationic proteins in the pathogenesis of immune complex glomerulonepjritis. Nephrol Dial Transplant 1990;5(Suppl 1):6–9.PubMedGoogle Scholar
  5. 5.
    Sorger K, Gessler U, Hübner FK et al. Subtypes of acute postinfectious glomerulonephritis. Synopsis of clinical and pathological features. Clin Nephrol 1982;17:114–128.PubMedGoogle Scholar
  6. 6.
    von Plecniz MA. Tractatus III de Scarlatina. Trattner JA, Vienna 1972. Cited by Becker CG, Murphy GE. The experimental induction of glomerulonephritis like that in man by infection with Group A streptococci. J Exp Med 1968;127:1–23.CrossRefGoogle Scholar
  7. 7.
    Dochez AR, Sherman L. The signifcance of Streptococcus hemolyticus in scarlet fever and he preparation of a specific antiscarlatinal serum by immunization of the horse to Streptococcus hemolyticus. J Am Med Assoc 1924;82:542–544.CrossRefGoogle Scholar
  8. 8.
    Little JD, Seegal D, Loeb EN et al. The serum anti-streptoysin titer in acute glomerulonephritis. J Clin Invest 1938;17:632–639.Google Scholar
  9. 9.
    Futcher PH. Glomerular nephritis following skin infections. Arch Intern Med 1940;65:1192–1210.CrossRefGoogle Scholar
  10. 10.
    Rodriguez-Iturbe B, Batsford S. Patyhogenesis of poststreptococcal glomerulonephritis a century after Clemens von Pirquet. Kidney Int 2007;71:1094–1104.PubMedCrossRefGoogle Scholar
  11. 11.
    Montseny JJ, Meyrier A, Kleinknecht D et al. The current spectrum of infectious glomerulonephritis. Experience with 76 patients and review of the literature. Medicine (Baltimore) 1995;74:63–73.CrossRefGoogle Scholar
  12. 12.
    Balter S, Benin A, Pinto SW et al. Epidemic nephritis in Nova Serrana, Brazil. Lancet 2000;355:1776–1780.PubMedCrossRefGoogle Scholar
  13. 13.
    Thongboonkerd V, Luengpailin J, Cao J, Pierce WM, Cai J, Klein JB, Doyle RJ. Fluoride exposure attenuates expression of Streptococcus pyogenes virulence factors. J Biol Chem 2002;277:16599–16605).PubMedCrossRefGoogle Scholar
  14. 14.
    Carapetis JR, Steer AC, Mullholand EK et al. The global burden of group A streptococcal diseases. Lancet 2005;5:685–694.Google Scholar
  15. 15.
    Rodriguez-Iturbe B, Musser JM. The current state of poststreptococcal glomerulonephritis. J Am Soc Nephrol 2008 (in press).Google Scholar
  16. 16.
    Rammelkamp CH, Weaver RS, Dingle JH. Significance of the epidemiologic differences between acute nephritis and acute rheumatic fever. Trans Assoc Am Physicians 1952;65:168–175.PubMedGoogle Scholar
  17. 17.
    Segal D, Earle DP. A consideration of certain biological differences between glomerulonephritis and rheumatic fever. Am J Med Sci 1941;201:528–539.CrossRefGoogle Scholar
  18. 18.
    Parra G, Rodrìguez-Iturbe B, Batsford S et al. Antibody to streptococcal zymogen in the serum of patients with acute glomerulonephritis: a multicentric study. Kidney Int 1998;54:509–517.PubMedCrossRefGoogle Scholar
  19. 19.
    Batsford SR, Mezzano S, Mihatsch M et al. Is the nephritogenic antigen in post-streptococcal glomerulonephritis pyrogenic exotoxin B (SPE B) or GAPDH? Kidney Int 2005;68:1120–1129.PubMedCrossRefGoogle Scholar
  20. 20.
    Yoshizawa N, Yamakami K, Fujino M et al. Nephritis-associated plasmin receptor and acute poststreptococcal glomerulonephritis: characterization of the antigen and associated immune response. J Amer Soc Nephrol 2004;15:1785–1793.CrossRefGoogle Scholar
  21. 21.
    Oda T, Yamakami K, Omasu F et al. Glomerular plasmin-like activity in relation to nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis. J Amer Soc Nephrol 2005;16:247–254.CrossRefGoogle Scholar
  22. 22.
    Them A, Stenberg L, Dahback B et al. Ig-binding surface proteins of Streptococcus pyogenes also bind human C4b-binding protein (C4bP), a regulatory component of the complement system. J Immunol 1995;154:375–386.Google Scholar
  23. 23.
    Perez-Caballero D, Garcia-Laorden I, Cortes G et al. Interaction between complement regulators and Streptococcus pyogenes: binding of C4b-binding protein and factor H/factor H-like protein 1 to M18 strains involve two different cell surface molecules. J Immunol 2004;173:6899–6904.PubMedGoogle Scholar
  24. 24.
    Hisano S, Matsushita M, Fujita T et al. Activation of the lectin complement pathway in post-streptococcal acute glomerulonephritis. Pathol Int 2007;57:351–357.PubMedCrossRefGoogle Scholar
  25. 25.
    Parra G, Platt JL, Falk, RJ et al. Cell populations and membrane attack complex in glomeruli and patients with poststreptococcal glomerulonephritis: identification using monoclonal antibodies by indirect immunofluorescence. Clin Exp Immunol Immunopathol 1984;33:324–332.CrossRefGoogle Scholar
  26. 26.
    Parra G, Romero M, Henríquez-LaRoche C et al. Expression of adhesion molecules in poststreptococcal glomerulonephritis. Nephrol Dial Transplant 1994;9:1412–1414.PubMedGoogle Scholar
  27. 27.
    Ardiles LG, Valderrama G, Moya P et al. Incidence and studies on antigenic specificities of antineutrophil-cytoplasmic autoantibodies (ANCA) in poststreptococcal glomerulonephritis. Clin Nephrol 1997;47:1–5.PubMedGoogle Scholar
  28. 28.
    Parra G, Platt JL, Falk RJ et al. Cell populations and membrane attack complex in the glomeruli of patients with poststreptococcal glomerulonephritis: identification using monoclonal antibodies by indirect fluorescence. Clin Immunol Immunopathol 1984;33:324–332.PubMedCrossRefGoogle Scholar
  29. 29.
    Parra G, Romero M, Henriquez-La Roche C et al. Expression of adhesion molecules in poststreptococcal glomerulonephritis. Nephrol Dial Transplant 1994;9:1412–1417.PubMedGoogle Scholar
  30. 30.
    Horii Y, Iwano M, Hirata E et al. Role of interleukin-6 in the progression of mesangial proliferative glomerulonephritis. Kidney Int 1993;39(Suppl):S71–S75.Google Scholar
  31. 31.
    Pedreanez A, Viera N, Rincon J, Mosquera J et al. Increased IL-6 in supernatant of rat mesangial cell cultures treated with erythrogenic toxin type B and its precursor isolated from nephritogenic streptococci. Am J Nephrol 2006;26:75–81.PubMedCrossRefGoogle Scholar
  32. 32.
    Mezzano S, Burgos ME, Olavarría F et al. Immunohistochemical localization of IL-8 and TGF-beta in streptococcal glomerulonephritis. J Am Soc Nephrol 1997;8:234–241.PubMedGoogle Scholar
  33. 33.
    Yokohama H, Takaeda M, Wada T et al. Glomerular ICAM-1 expression related to circulating TNF-alpha in human glomerulonephritis. Nephron 1997;76:425–433.CrossRefGoogle Scholar
  34. 34.
    Rodriguez-Iturbe B. Acute endocapillary glomerulonephritis. In Oxford Textbook of Clinical Nephrology, 3rd edn. Davison A, Cameron JS, Grünfeld JP, Ponticelli C, Ritz E, Winearls CG, van Ypersele C (eds.). Oxford University Press, Oxford, 2005, pp. 545–557.Google Scholar
  35. 35.
    Anthony BF, Kaplan EL, Wannamaker LW et al. Attack rates of acute nephritis after type 49 streptococcal infections of the skin and of the respiratory tract. J Clin Invest 1969;48:1697–704.PubMedCrossRefGoogle Scholar
  36. 36.
    Dodge WF, Spargo BF, Travis LB. Occurrence of acute glomerulonephritis in sibling contacts of children with sporadic acute glomerulonephritis. Pediatrics 1967;40:1028–1030.PubMedGoogle Scholar
  37. 37.
    Rodriguez-Iturbe B, Rubio L, Garcia R. Attack rate of poststreptococcal glomerulonephritis in families. A prospective study. Lancet 1981;1:401–403.PubMedCrossRefGoogle Scholar
  38. 38.
    Juncos LI. Intrarenal mechanisms of salt and water retention in the nephritic syndrome. Kidney Int 2002;61:1182–1195.PubMedCrossRefGoogle Scholar
  39. 39.
    Kim SW, Frøkiaer J, Nielsen S. Pathogenesis of oedema in nephrotic syndrome: role of epithelial sodium channel. Nephrology 2007;12(Suppl)3:S8–S10.PubMedCrossRefGoogle Scholar
  40. 40.
    Rodríguez-Iturbe B, Herrera-Acosta J, Johnson RJ. Interstitial inflammation, sodium retention, and the pathogenesis of nephrotic edema: a unifying hypothesis. Kidney Int 2002;62:1379–1384.PubMedCrossRefGoogle Scholar
  41. 41.
    Rodriguez-Iturbe B. Epidemic poststreptococcal glomerulonephritis (Nephrology Forum). Kidney Int 1984;25:129–136.PubMedCrossRefGoogle Scholar
  42. 42.
    Sorger K, Gessler M, Hübner FK et al. Follow-up studies of three subtypes of acute postinfectious glomerulonephritis ascertained by renal biopsy. Clin Nephrol 1987;27:111–124.PubMedGoogle Scholar
  43. 43.
    Soto HM, Parra G, Rodríguez-Iturbe B. Circulating levels of cytokines in poststreptococcal glomerulonephritis. Clin Nephrol 1997;47:6–12.PubMedGoogle Scholar
  44. 44.
    Drut R, Drut RM. Mesangiolytic poststreptococcal glomerulonephritis. Pediatric Pathol 1992;12:113–117.CrossRefGoogle Scholar
  45. 45.
    Gallo GR, Feiner HD, Steele JM Jr et al. Role of intrarenal vascular sclerosis in progression of poststreptococcal glomerulonephritis. Clin Nephrol 1980;13:449–457.Google Scholar
  46. 46.
    Cebul DR, Poses RM. The comparative cost-effectiveness of statistical decision rules and experienced physicians in pharyngitis management. J Am Med Assoc 1986;256:3353–3357.CrossRefGoogle Scholar
  47. 47.
    McIsaac WJ, White D, Tannenbaum D et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. Can Med Assoc J 1998;158:75–83.Google Scholar
  48. 48.
    American Academy of Pediatrics, Committee on Infectious Diseases: Group A streptococcal infections. In The Red Book. Elk Groove Village, II. American Academy of Pediatrics 2000, pp. 526–592.Google Scholar
  49. 49.
    Webb KH, Needham CA, Kurtz SR. Use of a high-sensitivity rapid strep test without culture confirmation of negative results: 2 years’ experience. J Fam Prac 2000;49:34–36.Google Scholar
  50. 50.
    Zoch-Zwierz W, Wasilewska A, Biernacka A et al. The course of post-streptococcal glomerulonephritis depending on methods of treatment of the preceding respiratory tract infection. Wiad Lek 2001;54:56–63.PubMedGoogle Scholar
  51. 51.
    Billal DS, Hotomi M, Yamauchi K et al. Macrolide-resistant genes of Streptococcus pyogenes isolated from the upper respiratory tract by polymerase chain reaction. J Infect Chemother 2004;10:115–120.PubMedCrossRefGoogle Scholar
  52. 52.
    Tamayo J, Pérez-Trallero E, Gómez-Garcés JL et al. Resistance to macrolides, clindamycin and telithromycin in Streptococcus pyogenes isolated in Spain during 2004. J Antimicrob Chemother 2005;56:780–782.PubMedCrossRefGoogle Scholar
  53. 53.
    Richter SS, Heilmann KP, Beekmann SE et al. Macrolide-resistant Streptococcus pyogenes in the United States, 2002–2003. Clin Infect Dis 2005;41:599–608.PubMedCrossRefGoogle Scholar
  54. 54.
    Richter SS, Heilmann KP, Dohrn CL et al. Increasing telithromycin resistance among Streptococcus pyogenes in Europe. J Antimicrob Chemother 2008;61:603–611.PubMedCrossRefGoogle Scholar
  55. 55.
    Johnston F, Carapetis J, Patel MS et al. Evaluating the use of penicillin to control outbreaks of acute poststreptococcal glomerulonephritis. Pediatr Infec Dis J 1999;18:327–332.CrossRefGoogle Scholar
  56. 56.
    Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: an update. Curr Opin Pediatr 2008;20:157–162.PubMedCrossRefGoogle Scholar
  57. 57.
    Potter EV, Lipschultz SA, Abidh S et al. Twelve to seventeen-year follow up of patients with acute poststreptococcal glomerulonephritis in Trinidad. N Engl J Med 1982;307:725–729.PubMedCrossRefGoogle Scholar
  58. 58.
    Baldwin DS, Gluck MC, Schacht RG et al. The long-term course of poststreptococcal glomerulonephritis. Ann Intern Med 1974;80:342–358.PubMedGoogle Scholar
  59. 59.
    White AV, Hoy WE, McCredie DA. Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life. Med J Austral 2001;174:492–494.PubMedGoogle Scholar
  60. 60.
    Sesso R, Pinto SWL. Five-year follow-up of patients with epidemic glomerulonephritis due to Streptococcus zooepidemicus. Nephrol Dial Transplant 2005;20:1808–1813.PubMedCrossRefGoogle Scholar
  61. 61.
    Eknoyan G. Renal complications of bacterial endocarditis. Am J Nephrol 1985;5:457–469.PubMedCrossRefGoogle Scholar
  62. 62.
    Neugarten J, Baldwin DS. Glomerulonephritis in bacterial endocarditis. Am J Med 1984;77:297–304.PubMedCrossRefGoogle Scholar
  63. 63.
    Majumdar A, Chowdhary S, Ferreira MAS et al. Renal pathological findings in infective endocarditis. Nephrol Dial Transplant 2000;15:1782–1787.PubMedCrossRefGoogle Scholar
  64. 64.
    Paterick TE, Paterick TJ, Nishimura RA et al. Complexity and subtlety of infective endocarditis. Mayo Clin Proc 2007;82:615–621.PubMedCrossRefGoogle Scholar
  65. 65.
    Tlevjeh IM, Steckelberg JM, Murad HS et al. Temporal trends in infective endocarditis: a population-based study in Olmsted County, Minnesota. J Am Med Ass 2005;293:3022–3028.CrossRefGoogle Scholar
  66. 66.
    Tleyjeh IM, Abdel-Latif A, Rahbi H et al. A systematic review of population-based studies of infective endocarditis. Chest 2007;132:1025–1035.PubMedCrossRefGoogle Scholar
  67. 67.
    Hoen B. Infective endocarditis: a frequent disease in dialysis patients. Nephrol Dial Transplant 2004;19:1360–1362.PubMedCrossRefGoogle Scholar
  68. 68.
    Yum M, Wheat LJ, Maxwell D et al. Immunofluorescent localization of Staphylococcus aureus antigen in acute bacterial andocarditis. Am J Clin Pathol 1978;70:832–835.PubMedGoogle Scholar
  69. 69.
    Koyama A, Kobayashi M, Yamaguchi N et al. Glomerulonephritis associated with MRSA infection: a possible role of bacterial superantigen. Kidney Int 1995;47:207–216.PubMedCrossRefGoogle Scholar
  70. 70.
    Yoh K, Kobayashi M, Yamaguchi N et al. Cytokines and T-cell responses in superantigen-related glomerulonephritis following methicillin-resistant Staphylococcus aureus infection. Nephrol Dial Transplant 2000;15:1170–1174.PubMedCrossRefGoogle Scholar
  71. 71.
    Doulton T, Sabharwal N, Cairns HS et al. Infective endocarditis in dialysis patients: new challenges and old. Kidney Int 2003;64:720–727.PubMedCrossRefGoogle Scholar
  72. 72.
    McCarthy JT, Steckelberg JM. Infective endocarditis in patients receiving long-term hemodialysis. Mayo Clin Proc 2000;75:1008–1014.PubMedCrossRefGoogle Scholar
  73. 73.
    Nori US, Manoharan A, Thornby JI et al. Mortality risk factors in chronic haemodialysis patients with infective endocarditis. Nephrol Dial Transplant 2006;21:2184–2190.PubMedCrossRefGoogle Scholar
  74. 74.
    Yoshinaga M, Niwa K, Niwa A et al. Risk factors for in-hospital mortality during infective endocarditis in patients with congenital heart disease. Am J Cardiol 2008;101:114–118.PubMedCrossRefGoogle Scholar
  75. 75.
    Venkatesan C, Wainwright MS. Pediatric endocarditis and stroke: a single-center retrospective review of seven cases. Pediatr Neurol 2008;38:243–247.PubMedCrossRefGoogle Scholar
  76. 76.
    Conlon PJ, Jefferies F, Krigman HR et al. Predictors of prognosis and risk of acute renal failure in bacterial endocarditis. Clin Nephrol 1998;49:96–101.PubMedGoogle Scholar
  77. 77.
    Agarwal A, Clemens J, Sedmark DD, et al. Subacute bacterial endocarditis masquerading as type III essential mixed cryoglobulinemia. J Am Soc Nephrol 1997; 8:1971–1976.PubMedGoogle Scholar
  78. 78.
    Fukuda M, Motokawa M, Usami T et al. PR3-ANCA-positive crescentic necrotizing glomerulonephritis accompanied by isolated pulmonic valve infective endocarditis, with reference to previous reports of renal pathology. Clin Nephrol 2006;66:202–209.PubMedGoogle Scholar
  79. 79.
    Choi HK, Lamprecht P, Niles JL et al. Subacute bacterial endocarditis with positive cytoplasmic antineutrophil cytoplasmic antibodies and anti-proteinase 3 antibodies. Arthritis Rheum 2000;43:226–231.PubMedCrossRefGoogle Scholar
  80. 80.
    Badour LM, Wilson WR, Bayer AS et al. Infective endocarditis. Diagnosis, antimicrobial therapy and management of complications. Circulation 2005;111:3167–3184.CrossRefGoogle Scholar
  81. 81.
    Haffner D, Schinderas F, Aschoff A. The clinical spectrum of shunt nephritis. Nephrol Dial Transplant 1997;12:1143–1148.PubMedCrossRefGoogle Scholar
  82. 82.
    Black JA, Chaacombe DN, Ockenden BG. Nephrotic syndrome associated with bacteraemia after shunt operations for hydrocephalus. Lancet 1965;2:921–924.PubMedCrossRefGoogle Scholar
  83. 83.
    Fukada Y, Ohtomo Y, Kaneko K et al. Pathologic and laboratory dynamics following the removal of the shunt in shunt nephritis. Am J Nephrol 1993;13:78–82.CrossRefGoogle Scholar
  84. 84.
    Dobrin RS, Day NK, Quie PG et al. The role of complement, immunoglobulin and bacterial antigens in coagulase-negative Staphylococcus shunt nephritis. Am J Med 1975;59:660–673.PubMedCrossRefGoogle Scholar
  85. 85.
    Groeneveld AGJ, Nommensen FE, Mallink H et al. Shunt nephritis associated with Propionibacterum acnes with demonstration of the antigen in the glomeruli. Nephron 1982;32:365–369.PubMedCrossRefGoogle Scholar
  86. 86.
    Hunte W, Ghraoui F, Cohen RJ. Secondary syphilis and nephrotic syndrome. J Am Soc Nephrol 1993;3:1351–1355.PubMedGoogle Scholar
  87. 87.
    Soehardy Z, Hayati SN, Rozita M et al. Subclinical acquired syphilis masquerading as membranous glomerulonephritis. Med J Malaysia 2006;61:484–486.PubMedGoogle Scholar
  88. 88.
    O’Regan S, Fong JS, de Chadarévian JP et al. Treponemal antigens in congenital and acquired syphilitic nephritis: demonstration by immunofluorescence studies. Ann Intern Med 1976;5:325–327.Google Scholar
  89. 89.
    Chugh KS, Sakhuja V. Glomerular disease in the tropics. Am J Nephrol 1990;10:437–450.PubMedCrossRefGoogle Scholar
  90. 90.
    Phillips J, Palmer A, Baliga R. Glomerulonephritis associated with acute pneumococcal pneumonia: a case report. Pediatr Nephrol 2005;20:1494–1495.PubMedCrossRefGoogle Scholar
  91. 91.
    Beaufils M, Morel-Maroger L, Sraer JD et al. Acute renal failure of glomerular origin during visceral abscesses. N Engl J Med 1976;295:185–189.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

There are no affiliations available

Personalised recommendations