Nephritic syndrome

Nephritic syndrome is a syndrome comprising signs of nephritis, which is kidney disease involving inflammation. It often occurs in glomerulonephritis, which is characterized by a thin glomerular basement membrane and small pores in the podocytes of the glomerulus, large enough to permit proteins and red blood cells to pass into the urine (yielding proteinuria and hematuria). By contrast, nephrotic syndrome is characterized by only proteins moving into the urine. Nephritic syndrome, like nephrotic syndrome, may involve hypoalbuminemia due to the protein albumin moving from the blood to the urine.

Nephritic syndrome
Other namesAcute nephritic syndrome[1]
Hematuria (one of the symptoms of Nephritic syndrome)
SpecialtyNephrology 
CausesInfectious, autoimmune, or thrombotic[2]
Diagnostic methodUrinalysis, kidney biopsy[3]
TreatmentAntihypertensives [4]

Signs and symptoms

Historically, nephritic syndrome has been described to present with the classical triad of hematuria, hypertension and azotemia with subsequent renal failure. This triad contrasts with the classical pentad of nephrotic syndrome (Edema, proteinuria, dyslipidemia, lipiduria and hypoalbuminemia)[5]

Symptoms and signs of nephritic syndrome are consistent with:

Cause

Purpura

Nephritic syndrome is caused by inflammation of glomerulus, and has urine waste; furthermore the cause can be infectious, autoimmune, or thrombotic.[2] The causes can be divided between age groups as:[3]

Children/adolescents

Adults

Pathophysiology

The pathophysiology of nephritic syndrome is dependent on where damage is done by antibody-antigen complexes (in the glomerulus). In the case of IgA nephropathy, the glomerulus cannot filter IgA antibody-antigen, and this causes an inflammatory response, then release of cytokines (and growth factors), and finally results in glomerular scarring.[9]

Diagnosis

The classic diagnoses of nephritic syndrome is post-streptococcal glomerulonephritis,[10] which is a common complication of Streptococcus bacterial infections, typically of the skin. Among the tests done to diagnose if an individual has nephritic syndrome are: blood electrolytes, blood urea nitrogen, potassium test, protein in the urine, urinalysis and kidney biopsy.[3]

Treatment

Treatment of nephritic syndrome is consistent with administration of antihypertensives and anti-inflammatory medication. Furthermore, treatment includes a reduction in potassium (K+) and salt, as well as physical rest.[3]

Prognosis

Because nephritic syndrome is not a disease, the prognosis depends on the underlying cause. The prognosis of nephritic syndrome in children due to poststreptococcal glomerulonephritis is good.[4]

References

  1. "acute nephritic syndrome" at Dorland's Medical Dictionary
  2. Schrier, Robert W. (2008-10-01). Manual of Nephrology. Lippincott Williams & Wilkins. pp. 144–145. ISBN 9780781796194.
  3. "Acute nephritic syndrome: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-10-27.
  4. "Acute Nephritis; Nephrosis; Nephritic syndrome information. Patient | Patient". Patient. Retrieved 2015-10-27.
  5. Floege, Jürgen; Johnson, Richard J.; Feehally, John (2010). Comprehensive Clinical Nephrology (Fourth Edition). Mosby. p. 198. doi:10.1016/B978-0-323-05876-6.00015-0. ISBN 9780323058766.
  6. Schrier, Robert W. (2010-01-01). Renal and Electrolyte Disorders. Lippincott Williams & Wilkins. p. 560. ISBN 9781608310722.
  7. Krueger, Gerhard R. F.; Buja, L. Maximilian (2013-03-12). Atlas of Anatomic Pathology with Imaging: A Correlative Diagnostic Companion. Springer Science & Business Media. p. 287. ISBN 9781447128465.
  8. Madara, Bernadette; Pomarico-Denino, Vanessa (2008-07-08). Quick Look Nursing: Pathophysiology. Jones & Bartlett Learning. p. 484. ISBN 9780763749323.
  9. Goodman, Catherine C.; Fuller, Kenda S. (2014-11-05). Pathology: Implications for the Physical Therapist. Elsevier Health Sciences. p. 980. ISBN 9780323291224.
  10. "Acute Poststreptococcal Glomerulonephritis: Background, Pathophysiology, Epidemiology". 2018-12-05. Cite journal requires |journal= (help)

Further reading

  • Crutchlow, Eileen M.; Dudac, Pamela J.; MacAvoy, Suzanne; Madara, Bernadette R. (2002-01-01). Pathophysiology. Jones & Bartlett Learning. ISBN 9781556425653.
  • Schrier, Robert W. (2014-05-13). Manual of Nephrology. Lippincott Williams & Wilkins. ISBN 9781469887364.
Classification
External resources
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