Some children with glomerulonephritis do not have any symptoms, especially in the early stages of the disease. When symptoms do occur, these can include:

• blood in the urine (haematuria) – you cannot always see the blood, but if there is a lot, the urine may be red or dark brown (like a cola drink)
• protein in your child’s urine (proteinuria) – this is likely to only be seen under a microscope or when tested by dipping a specially treated paper strip into your child’s urine (urine dipstick). However, if there is a lot of protein, their urine may look frothy.
• urinating less often or smaller amounts
• swelling or puffiness (oedema) – especially around your child’s eyes and ankles. Swelling around the eyes tends to be worse first thing in the morning and improve as the day goes on whereas ankle swelling is usually worse in the evenings. The swelling is soft and puffy and leaves a dent if you press on it. It does not cause any pain. It is not an allergic reaction but is caused by the kidneys retaining too much water.
• swelling in the tummy (ascites) – this happens when fluid builds up in the area around the organs in the abdomen (the peritoneal cavity).
• breathlessness – this happens when fluid builds up in the area around their lungs.

If your child has glomerulonephritis and a very swollen tummy or feels breathless, contact your doctor as soon as possible.

Acute nephritic syndrome

Some children present with a pattern called acute nephritic syndrome. This is when several symptoms appear together over a few days:

• blood in the urine (haematuria) - the urine may look red, brown or the colour of cola
• passing less urine than usual
• swelling (oedema), especially around the eyes and ankles
• high blood pressure (hypertension)

Acute nephritic syndrome needs to be seen by a doctor the same day.

Complications

Some children have complications – health problems that happen because of their glomerulonephritis. These can include:

• hypertension - high blood pressure
• nephrotic syndrome – too much protein is lost in the urine
• acute kidney injury – a sudden drop in kidney function

Occasionally, the condition gets worse quickly and the kidneys work less well than normal – this is called rapidly progressive glomerulonephritis (RPGN).

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