Analysis of the urine shows the presence of erythrocytes, albumin, and casts. Another symptom is edema of the face or ankles, more common in the morning than in the evening. The blood pressure usually rises during acute nephritis, and in severe cases hypertension may be accompanied by convulsions. Treatment consists chiefly of bed rest and a carefully controlled diet. Penicillin is often used if an earlier streptococcal infection is still lingering.
Recovery is usually complete.
In a small percentage of cases, however, acute nephritis resists complete cure. It may subside for a time and then become active again, or it may develop into chronic nephritis. Dialysis may be indicated in patients with fluid overload that is refractory to diuretics, or who become clinically uremic. Chronic nephritis may follow a case of acute nephritis immediately or it may develop after a long interval during which no symptoms have been present. Many cases of chronic nephritis occur in people who have never had the acute form of the disease.