What are clinical features of acute postinfectious glomerulonephritis?

➢The most common clinical presentation is acute nephritic syndrome. ➢Edema and hypertension are common, with mild to moderate azotemia. ➢Characteristically, there is gross hematuria, the urine appearing smoky brown rather than bright red due to oxidation of hemoglobin to methemoglobin. ➢Some degree of proteinuria is a constant feature, and it occasionally may be severe enough to produce the nephrotic syndrome. ➢ Serum complement levels are low during the active phase of the disease, and serum anti–streptolysin O antibody titers are elevated in poststreptococcal cases. ➢ Recovery occurs in most children with poststreptococcal disease, but some develop rapidly progressive GN owing to severe injury with formation of crescents, or chronic renal disease from secondary scarring. ➢ The prognosis in sporadic cases is less clear. ➢ In adults, 15% to 50% of affected individuals develop end-stage renal disease over a few years or 1 to 2 decades, depending on the clinical and histologic severity. ➢ By contrast, in children with sporadic cases of acute postinfectious GN, the progression to chronicity is much lower