Complications of Acute Glomerulonephritis: What You Need to Know

Acute glomerulonephritis is an inflammatory condition of the kidney's glomeruli, typically triggered by a preceding infection—most commonly streptococcal. This sudden immune-mediated response damages the filtering units of the kidneys, leading to a range of systemic complications. While many cases resolve with proper treatment, early recognition of potential complications is crucial for effective management and improved patient outcomes.

Common Complications Associated with Acute Glomerulonephritis

The inflammation in the glomeruli disrupts normal kidney function, which can rapidly lead to serious health issues. Below are the primary complications that may arise during the course of acute glomerulonephritis.

1. Acute Left-Sided Heart Failure

Fluid retention due to impaired kidney function can result in volume overload, increasing pressure on the cardiovascular system. Patients may develop symptoms such as severe edema (particularly in the legs and ankles), shortness of breath, and orthopnea—the inability to lie flat without experiencing respiratory distress. In more severe cases, pulmonary congestion may occur, requiring urgent medical intervention including diuretics and blood pressure control.

2. Hypertension (High Blood Pressure)

Renal inflammation often triggers a rise in blood pressure due to sodium and water retention, along with activation of the renin-angiotensin-aldosterone system (RAAS). Uncontrolled hypertension can further damage the kidneys and increase the risk of stroke or heart disease. Monitoring blood pressure regularly and initiating antihypertensive therapy when necessary are key components of patient care.

3. Acute Kidney Injury (AKI)

One of the most concerning complications is a rapid decline in kidney function, known as acute kidney injury. This manifests through elevated serum creatinine levels, reduced urine output (oliguria), and electrolyte imbalances such as hyperkalemia or metabolic acidosis. In some cases, temporary dialysis may be required to support renal function until recovery begins.

4. Systemic Infections

Patients with acute glomerulonephritis may experience compromised immune defenses due to both the underlying disease process and associated proteinuria, which can lead to loss of immunoglobulins. This weakened immunity increases susceptibility to secondary bacterial or viral infections, including pneumonia, urinary tract infections, or sepsis. Preventive measures such as good hygiene, vaccination, and prompt treatment of any signs of infection are essential.

In summary, while acute glomerulonephritis is often self-limiting, its potential complications demand close clinical monitoring. Early diagnosis, supportive care, and timely intervention can significantly reduce morbidity and improve long-term prognosis. If you or someone you know shows signs of this condition—especially following a recent infection—consult a healthcare provider promptly for evaluation and management.