Urine is Not Supposed to Look Like This

In all your life this is mostly probably the first time you’ve ever seen anything like this – that means it’s important!


Acute proliferative glomerulonephritis

  • Also known as:

poststreptococcal glomerulonephritis, or

infection-related glomerulonephritis, or

bacterial infection-related glomerulonephritis

  • Is the result of a strep infection

○ most typically Impetigo but it can also occur after strep pharyngitis

○ most commonly occurs in children

  • That results in a hypersensitivity reaction by the immune system
  • Causing inflammation and damage in the kidneys and can even be fatal

○ In 2013 acute glomerulonephritis resulted in 19,000 fatalities

This is not something to take lightly if considered or once diagnosed.

  • It typically occurs about 3 weeks after the original infection – about as much time as it takes the body to raise the antibodies it’s going to use against the strep organism causing the infection.
  • In what’s called an ‘Immune-Complex-Mediated Hypersensitivty Reaction’ the antibodies that are created to bind and remove the strep organism but inadvertently ALSO bind to sites within the glomeruli of the kidney – the glomeruli are the individual elements within the kidney that actually filter the blood and create urine.
  • When these antibodies accidentally bind to the glomeruli and the blood vessels surrounding them the body’s complement proteins are activated and the glomeruli are essentially marked for destruction. They begin to swell, they become damaged; and kidney function becomes compromised.
  • As this process progress some very classic signs and symptoms begin to appear:

○ Hematuria – red blood cells seeping through the damaged glomeruli and showing up in the urine and causing it to look the way it did in todays picture

○ Oliguria – decreased urine production that in this instance is worrisome for progressing/impending renal failure

○ Edema – diffuse swelling within the limbs and soft tissue

○ Hypertension – increased blood pressure with decreased blood flow through the kidneys, and

Constitutional symptoms such fever, headache, malaise, anorexia, and nausea

  • Once at your doctor they would take full stock of your presentation and:

Consider several other potential causes of acute glomerulonephritis such as;

IgA Nephropathy

Lupus nephritis

Type I membraneoproliferative glomerulonephritis

Bacterial Endocarditis


Nephrotic Syndrome

As well as consider other causes of generalized edema such as;



Liver Failure

Right Heart Failure


○ And as part of your work-up they may consider;

Blood tests

A Complement profile

Imaging studies

Kidney biopsy

● Treatment may include antibiotics to treat the infection; controlling blood pressure; controlling inflammation; and dietary considerations.