Q: 67 years old school principal is transferred from a rural community hospital with the diagnosis of poststreptococcal glomerular nephritis (PSGN). Patient on arrival to ICU was found to be hypertensive. Chest X-ray showed pulmonary edema. An immediate renal biopsy followed by dialysis is required?
A) Yes
B) No
Answer: B
PSGN is common in children and adults over the age of 60. Treatment is supportive and dialysis is rarely required if severe acidosis, electrolyte imbalance, and massive volume overload stays refractory to medical management. Although, obese and diabetic patients are more prone to go in renal failure.
Initial treatment includes diuresis with loop diuretics, blood pressure control, and water and sodium restrictions. Penicillin-based antibiotics or erythromycin are usually added, although their specific efficacy in PSGN is not certain.
#nephrology
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References:
1. Rawla P, Padala SA, Ludhwani D. Poststreptococcal Glomerulonephritis. [Updated 2021 Mar 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538255/
2. Rodriguez-Iturbe B, Musser JM. The current state of poststreptococcal glomerulonephritis. J Am Soc Nephrol 2008; 19:1855.
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