Post-Streptococcal Glomerulonephritis

Post-streptococcal glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) — or PSGN — is a kidney disease that can develop after certain skin and throat infections. You cannot give PSGN to other people. PSGN is most common in children, but adults are more likely to have long-term health problems if they get it. Provided below is information about what symptoms to be on the watch for, tests doctors use to diagnose PSGN, and treatment options. Practicing good hand hygiene and cough etiquette are important to prevent infections that can result in PSGN.

Causes

Post-streptococcal glomerulonephritis (PSGN) is a kidney disease that can develop after infections caused by bacteria called group A Streptococcus or group A strep. These infections include throat and skin infections like strep throat, scarlet fever, and impetigo. PSGN is not a group A strep infection of the kidneys, but instead is a result of the body’s immune system fighting off the group A strep throat or skin infection.

It usually takes about 10 days after strep throat or scarlet fever and about 3 weeks after a group A strep skin infection for PSGN to develop.

Spread to Others

You cannot catch PSGN from someone else, but group A strep can be spread from person to person. Group A strep live in the nose and throat and can easily spread to other people. When someone who is infected coughs or sneezes, the bacteria travel in small droplets of water called respiratory droplets. You can get a group A strep infection if you breathe in those droplets or if you touch something that has the droplets on it and then touch your mouth or nose. You could also become ill from group A strep if you drink from the same glass or eat from the same plate as a sick person. It is possible to get group A strep from touching sores on the skin caused by the bacteria (impetigo).

Although rare, group A strep can be spread through food if it is not handled properly (visit CDC’s food safety page). Pets or household items, like toys, are not known to spread these bacteria.

Signs and Symptoms

Symptoms of PSGN can include:

• Dark, reddish-brown urine
• Swelling (edema), especially in the face, around the eyes, and in the hands and feet
• Decreased need to pee or decreased amount of urine
• Feeling tired due to low iron levels in the blood (fatigue due to mild anemia)

In addition, someone with PSGN usually has:

• Protein in the urine
• High blood pressure (hypertension)

Some people may have no symptoms or symptoms that are so mild that they don’t seek medical help.

Risk Factors

Anyone can get PSGN after recovering from a sore throat (strep throat or scarlet fever) or skin infection (impetigo) caused by group A strep. The same people who are at increased risk of getting strep throat, scarlet fever, and impetigo, are also at increased risk of getting PSGN.

PSGN is more common in children than adults. Developing PSGN after strep throat or scarlet fever is most common in young, school-age children, while developing PSGN after impetigo is most common in preschool age children.

Diagnosis and Testing

Doctors diagnose PSGN by looking at your medical history and ordering lab tests. Your doctor can test urine samples to look for protein and blood. Doctors can also do a blood test to see how well the kidneys are working and to see if you recently had a group A strep infection.

Treatment

Treatment of PSGN focuses on managing symptoms as needed:

• Decreasing swelling (edema) by limiting salt and water intake or by prescribing a medication that increases the flow of urine (diuretic)
• Managing high blood pressure (hypertension) through blood pressure medication

In addition, people with PSGN who may still have group A strep in their throat are often provided antibiotics (medicine that kills bacteria in the body), preferably penicillin.

Complications

Most people who develop PSGN recover within a few weeks without any complications, but rarely long-term kidney damage, including kidney failure, can occur. These rare complications are more common in adults than children.

Prevention

The main way to prevent PSGN is to prevent group A strep infections like strep throat, scarlet fever, and impetigo. Getting a group A strep infection does not protect you from getting it again in the future and there are no vaccines to prevent group A strep. However, there are things you can do to protect yourself and others.

Hygiene

The best way to keep from getting or spreading group A strep is to wash your hands often, especially after coughing or sneezing and before preparing foods or eating. To practice good hygiene you should:

• Cover your mouth and nose with a tissue when you cough or sneeze
• Put your used tissue in the waste basket
• Cough or sneeze into your upper sleeve or elbow, not your hands, if you don't have a tissue
• Wash your hands often with soap and water for at least 20 seconds
• Use an alcohol-based hand rub if soap and water are not available

You should also wash glasses, utensils, and plates after someone who is sick uses them. After they have been washed, these items are safe for others to use.

Antibiotics

Someone with group A strep is usually not able to spread the bacteria to others after they have taken the correct antibiotic for 24 hours or longer. If you are diagnosed with a group A strep infection, you should stay home from work, school, or daycare until you no longer have a fever and have taken antibiotics for at least 24 hours so you don’t spread the infection to others.

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