N04.9/N05.9
DESCRIPTION
Acute glomerulonephritis presents with one or more of the following: haematuria, proteinuria, an acute decrease in eGFR, fluid retention, or hypertension.
GENERAL MEASURES
- Give oxygen, and place patient in semi-Fowler’s position if patient has respiratory distress.
- Early consultation with a specialist.
- Regulate fluid and electrolyte balance. Monitor weight closely.
- Dietary modification if severe kidney dysfunction, e.g. restrict salt, protein, potassium and phosphate intake.
- Avoid potential nephrotoxins: e.g. NSAIDs, aminoglycosides.
MEDICINE TREATMENT
Fluid overload
- Furosemide, as a slow IV bolus, 80 mg.
- Avoid unnecessary intravenous fluids.
If hypertension present: I12.0/I12.9
Diastolic BP >100 mmHg or systolic BP >150 mmHg:
- Amlodipine, oral, 5 mg as a single dose.
AND
- Hydrochlorothiazide, oral, 25 mg (if eGFR ≥30 mL/minute).
OR
Furosemide, oral, 40–80 mg (if eGFR <30 mL/minute).
Check all medicines for possible dose adjustments. http://www.globalrph.com/index_renal.htm
CONSULTATION/REFERRAL
The management of glomerular disease is individualised and management of all patients should be discussed with a specialist.