Nephritic syndrome (or acute 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.
Video Nephritic syndrome
Signs and symptoms
Symptoms and signs of nephritic syndrome are consistent with:
- Hematuria (blood in the urine)
- Proteinuria < 3.5g/d (protein in the urine)
- Hypertension
- Blurred vision
- Azotemia (increased blood Urea and Creatinine)
- Oliguria (low urine output <400 ml/day)
Maps Nephritic syndrome
Cause
Nephritic syndrome is caused by inflammation of glomerulus, and has urine waste; furthermore the cause can be infectious, autoimmune, or thrombotic. The causes can be divided between age groups as:
Children/adolescents
- IgA nephropathy
- Post-streptococcal glomerulonephritis
- Hemolytic uremic syndrome
- Henoch-Schönlein purpura
Adults
- Goodpasture syndrome
- SLE
- Rapidly progressing glomerulonephritis
- Infective endocarditis
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.
Diagnosis
The classic diagnoses of nephritic syndrome is post-streptococcal glomerulonephritis, 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.
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.
Prognosis
Because nephritic syndrome is not a disease, the prognosis depends on the underlying cause. The prognosis of nephritic syndome in children due to poststreptococcal glomerulonephritis is good.
References
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.
External links
- Nephritic syndrome - A to Z topics.
Source of the article : Wikipedia
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