Post-streptococcal glomerular nephritis


  • Abbreviation: PSGN
  • Most common cause of acute nephritis worldwide
  • Risk greatest in children 5-12 years old and adults >60
  • Caused by glomerular immune complex disease induced by specific nephritogenic strains of group A beta-hemolytic streptococcus (GAS)

Clinical Features

  • Varies from asymptomatic to microscopic hematuria to acute nephritic syndrome (gross hematuria, proteinuria, edema, hypertension, and acute kidney injury)
  • Most common features:
  • History of recent strep infection (e.g. strep pharyngitis, impetigo)

Differential Diagnosis

Causes of Glomerulonephritis


  • Typically diagnosed by acute nephritis + recent GAS infection (strep pharyngitis, impetigo)
  • CBC
  • Chem 7
  • Streptozyme assay including ASO
  • Complement C3, C4, C50
  • Urinalysis (dysmorphic red blood cells, varying degrees of proteinuria, red blood cell casts, and pyuria)


  • Supportive management (treat volume overload)
    • Sodium and water restriction
    • Furosemide (also controls hypertension)
      • ACEi or CCBs for hypertension not controlled by diuretics[1]
    • Consider dialysis (for acute renal failure)


  • Most have complete recovery, particularly children
  • Resolution begins within the first two weeks
  • Small subset have late renal complications (ie, hypertension, increasing proteinuria, and renal insufficiency)

See Also

Strep Pharyngitis


  1. Geetha D et al. Poststreptococcal Glomerulonephritis Medication. eMedicine, Nov 2017.
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