Nephritic syndrome

Question 1

What are some causes of nephritic syndrome?

Answer 1

Post-streptococcal glomerulonephritis
Systemic disease 
- vasculitis i.e GPA/EGPA
- anti-GBM disease
- Lupus
IgA nephropathy

Question 2

Blood tests for PSGN?

Answer 2

Antistreptolysin O titre - raised
DNase-B - raised
C3 levels - raised

Question 3

What is the time frame for PSGN vs IgA nephropathy?

Answer 3

Days - IgA nephropathy

Weeks - PSGN

Question 4

What is the systemic version of IgA nephropathy?

Answer 4

Henoch-Schonlein purpura

Question 5

Signs and symptoms of nephritic syndrome?

Answer 5

Mnemonic: PHAROAH

Proteinuria and edema
Haematuria
Azotemia
RBC casts
Oliguria
ASOT +ve (if post-strep)
Hypertension

Question 6

Blood tests for nephritic syndrome?

Answer 6

PSGN bloods i.e ASOT

Antibody screen: ANA, ANCA. anti-GBM

Question 7

Urine tests for nephritic syndrome?

Answer 7

Urinalysis + sedimentation examination

Albumin:creatinine ratio

Question 8

What casts might you see in nephritic syndrome which is pathognomic?

Answer 8

Red cell casts

Question 9

Treatment of nephritic syndrome?

Answer 9

Supportive Tx if post-streptococcal glomerulonephritis

Treat the underlying cause i.e immunosuppression/plasma exchange
Sodium and fluid restriction
ACE-i for proteinuria
Antibiotics to treat infection