Acute poststreptococcal glomerulonephritis (APSGN) is a sequela of group A β-hemolytic streptococci (GAS) infection of the skin or pharynx with strains of GAS that are nephrogenic. The onset of disease depends on the location of initial infection, with an average presentation of 10 days following pharyngitis and 3 weeks following a cellulitis. The etiology of the kidney damage is from deposition of antigen-antibody complexes in the glomeruli.

In the majority of cases of APSGN, the typical clinical presentation is a nephritic syndrome, including hematuria, mild proteinuria, edema, and hypertension with or without oliguria. Classically, the presentation of hematuria is heralded as “cola-colored” urine. The edema is typically noted first in the periorbital areas. Orthopnea, dyspnea, and cough may be other associated complaints related to volume overload. There may also be associated nonspecific findings including lethargy, anorexia, vomiting, fever, or headache.

Most clinicians start their evaluation of APSGN with analysis of the urine, which almost always reveals hematuria. Proteinuria is often present, correlating with the amount of blood in the urine. Additional laboratory evaluation may reveal signs of acute renal failure, including an elevation in the creatinine. Hyperkalemia and acidosis may also result.