Etiology:

• The beta-hemolytic streptococcus group A is most commonly involved.
• Other bacteria: pneumococci, meningococci, staphylococci …, hepatitis viruses

Signs and symptoms:

• Definition of angina, pharyngitis or skin infections: impetigo and scarlet fever within 10 to 15 days earlier
• asthenia,
• headache,
• hyperthermia,
• back pains,
• pain in the kidneys,
• edema, with feeling faces “inflated” sudden onset of diffuse, steep, which may affect the legs, loins, hands, face, abdominal pain with effusion, lung, brain, with weight gain,
• discoloration of urine (red-brown) due to hematuria,
• Hypertension in a person usually normo tense (as a result of GNA)
• oliguria (urine rare), urine “stock sale”
• hyperhydration with overload at heart (as a result of oliguria), which can lead to pulmonary edema.
• anorexia
• pallor

Diagnosis:

• ECBU reveals leucocyturia and significant proteinuria, hematuria and a microphone or even macroscopic cylinder with presence of erythrocytes and erythrocytes deformed.
• blood tests: The ESR is increased (indicating inflammation), leukocytosis. The balance is disturbed kidney with urea and creatinine levels.
• Renal ultrasound: it allows the differential diagnosis between chronic ANG and NG (CNG). When the CNG, will indeed find a kidney size decreased.
• looking for a site of infection, including streptococcal (ENT, stomatology, skin) and search for streptococcal antigens

Treatment:

• Penicillin in cases of post-streptococcal GNA.
• corticosteroids
• cyclophosphamide (Endoxan ®)
• azathioprine (Imurel ®)
• Symptomatic treatment of hypertension, edema and heart failure.
• bed rest 3 to 4 weeks, especially in cases of hypertension, edema or significant increase in serum creatinine (risk of renal failure)
• control pulse / voltage regular, and measuring the weight and temperature
• Monitoring urine with achieving a balance fluid
• monitoring of regular blood levels (urea, creatinine, electrolytes)
• Food: reduced intake of salt, liquid and protein. If hyperkalemia because of renal failure, lower potassium intake (bananas)
• required dialysis.

Prognosis:
Good in most cases.

• Renal failure, if it exists, will disappear in a few days.
• Hypertension was cured in a week.
• The macroscopic hematuria is microscopic in 2 to 3 weeks.
• Proteinuria decreased rapidly.
• Hematuria and proteinuria disappeared after no more than 18 ° month.
• Relapses are exceptional.

Long-term prognosis: no hypertension or renal disease.
Bad in the case of GN of autoimmune origin, with need for dialysis early.
A biopsy should be performed in cases of:

• anuria,
• renal failure for more than 2 weeks
• syndrome during beyond the 2nd week;
• Persistent hypertension after 2 weeks;
• proteinuria> 1g/24 h after 1 month;
• hematuria persisting after 18 months of evolution;
• relapse

Complications:
In the acute phase:

• threatening hypertension with cerebral edema, retinopathy and hypertensive pulmonary edema,
• anuria, which may take several sessions of extra renal treatment, but whose long-term prognosis is as good as the non-anuric forms.
• rapid deterioration of renal function.

Subsequently:

• Chronic renal failure

Chronic glomerulonephritis (CNG)
GN that develops over years, combined with a slowly progressive renal insufficiency. They may be secondary to another disease or looked so primitive.
The glomerular lesions are induced by antigen-antibody complex.

Etiology:

• often unknown
• complication of systemic lupus erythematosus (presence of circulating anti-DNA and antinuclear cell)
• complication of rheumatoid purpura (disease Schonlein-Henoch)
• complication of diabetes
• HIV infection

Signs and symptoms:

• Asymptomatic.
• Small hematuria, proteinuria, sometimes with nephrotic syndrome.
• Over time, appears hypertension, and signs of chronic renal failure.
• Histologically, the glomeruli are normal by light microscopy.

The renal biopsy (PBR) allows to establish the diagnosis, prognosis and treatment
Treatment:
There is no specific treatment. It is to this day on steroids.
Rest, diet low in protein. Symptomatic treatment.

Prognosis:
Rather bad. Patients find themselves inevitably one day in dialysis.