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Key Features

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  • Hematuria

  • Urinary red blood cell (RBC) casts

  • Hypertension

  • Edema

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Clinical Findings

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  • Hematuria may be microscopic or gross (often coffee- or tea-colored)

  • While RBC casts are often present, their absence does not exclude the diagnosis

  • Urine protein excretion may range from normal to nephrotic range

  • Edema (periorbital, facial, extremities, ascites) occurs due to salt and water retention with impaired glomerular function and contributes to systemic hypertension, which is further exacerbated by the glomerular inflammation and associated renin production

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Diagnosis

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  • Affected children require evaluation of blood pressure, renal function, serum albumin, and urine protein excretion

  • Serum C3 concentration is helpful in distinguishing certain types of acute glomerulonephritis

  • Renal biopsy may be indicated when the etiology is not clear from history and preliminary testing

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Treatment

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  • Diuretics followed by blockade of the renin-angiotensin-aldosterone system are the pillars of hypertension management

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