Acute Nephritic Syndrome

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Usually presents with facial or generalised oedema plus oliguria and hypertension. Check urine microscopy for active sediment and do U & Es daily. There may be a recent history of tonsillitis, arthralgia, skin rashes/ infection.

• Promote diuresis with small doses of oral frusemide (40-80mg once daily). If response obtained put on a regular dose.
• If post-streptococcal infection is suspected give:

Medicine	Dose	Frequency	Duration
Amoxicillin po	500mg	6 hourly	10 days

• Do not give steroids.
• Treat hypertension conventionally. Children need early intervention for elevated blood pressure.
• Restrict fluid if oliguric and carefully maintain fluid balance.
• If renal function is deteriorating, refer early to nephrologist/specialist physician or paediatrician.

NOTE: If the patient has signs of nephritic syndrome and U&Es monitoring is not available, REFER

• Once a diagnosis of nephritic syndrome is suspected make contact with physician/nephrologist whilst monitoring renal function DAILY. If renal function is deteriorating, REFER