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It is post streptococcal infective inflammatory process of glomerulus of the kidney leading to nephrotic syndrome characterised by

1. _Periorbital edema_
2. _Oliguria_( Reduced frequency of micturation & quantity 24hours -300 ml below)

• Age- 6-10 years of age
• Mode of onset – Acute, and 1-5 weeks after streptococcal pharyngeal infection
• History of sore throat
• History of scabies complicated with pyoderma

CAUSES

1. Streptococcus beta Haemolyticus group A (Nephrogenic strains)
2. Hepatitis B
3. Mumps
4. Pneumonia
5. _Good pasture syndrome_
6. _HSpurpura_ (Henoch-Schonlein Purpura)
7. Varicella

SYMPTOMS

1. Swelling of the face particularly on eyelid( _Periorbital edema_) gradually spread on whole body( decending type)
2. Moon face
3. _Haematuria_
4. _Oliguria_ sometimes anuria
5. Pain in loin
6. Hypertension
7. _Trachycardia_
8. Anemia
9. Jaundice – sometimes present due to Hepatitis B
10. Fever, Nausea, Vomiting

OTHER SYMPTOMS

1. Cyanosis – Sometimes present due to _LVH_

COMPLICATION

1. LVF
2. Hypertension
3. UTI and RTI
4. Hypertensive Encephalopathy
5. Cardiac Asthma
6. Secondary pulmonary edema
7. Acute renal failure

INVESTIGATION

1. Routine Examination of Urine :

• Oliguria
• Biochemical reaction – Mild to moderate present of protein in urine
• _RBC casts_
• High specific gravity of urine

2. Blood Test :

• TLC – Leucocytosis
• DLC – Neutrophilic leucocytosis
• Blood urea & nitrogen (BUN) 
• Serology Test – ASO titre increased more than 200
• Low haemoglobin
• ESR high

3. Urea creatinine sometime high
4. Renal Function Test 

• low Glomerular filtaration rate

5. Chest X-Ray

• Cardiac enlargement
• pulmonary congestion

6. CT scan of kidney
7. Kidney biopsy

• Introduction of flatus tube per rectum
• Colostomy or Ileostomy
• Laparoto

1. DIETARY CHANGES: that you eat less protein, salt and potassium
2. Dialysis
3. Immunosuppressant
4. Steroids
5. Medicine for hypertension, high cholesterol
6. Stop smoking
7. Plasma exchange