Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about nephritis in children.

And if you want to follow along with written notes on this topic,

you can follow along at zero tofinals.com slash nephritis

or in the renal and urology section of the zero definals pediatrics book.

So let's get straight into it.

Nephritis refers to inflammation within the nephrons of the kidneys,

and it causes a reduction in kidney function,

hematuria, which is invisible or visible amounts of blood in the urine, and protein

urea, although less protein in the urine than in nephotic syndrome.

The two most common causes of nephritis in children are post-streptococcal glomerula nephritis

and IGA nephropathy, which is also called Berger's disease.

So firstly, let's talk about post-streptoccal glomerula nephritis.

Post-streptoccal glomerula nephritis occurs one to three weeks after a beta-hemolyticlytic

infection such as tonsillitis caused by streptococcus pyogenes.

Immune complexes made of streptococcal antigens, antibodies and complement proteins get stuck in the glomeruli of the kidney and cause inflammation.

And this inflammation leads to an acute deterioration in kidney function causing an acute kidney injury.

It's worth considering a diagnosis of post-streptococcal glomerulinephritis where there is evidence of recent tonsilitis caused by streptococcus.

This evidence could be a history of tonsilitis, a positive throat swab, or antistreptolycin

antibodies, or ASO antibodies, seen on a blood test result.

Management of post-reptocococcus glomerulinephritis is supportive and around 80% of patients will make a full recovery.

In some cases, patients may develop a progressive worsening of their renal function and they may

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