Nephritic syndrome

Question 1

What is nephritic syndrome?

Answer 1

Nephritic syndrome is a syndrome comprising signs of nephritis, which is kidney disease involving inflammation. It often occurs in the glomerulus, where it is called glomerulonephritis.

Question 2

How do you distinguish nephrotic syndrome from nephritic syndrome?

Answer 2

Nephritic syndrome leads to haematuria

Question 3

What causes nephritic syndrome?

Answer 3

Nephritic syndrome is caused by extensive inflammatory damage to the glomerulus capillaries, which is associated with a variety of medical conditions

There a different causes for this inflammation:

1. Infectious
2. Autoimmune
3. Thrombotic

Question 4

What commonly causes nephritic syndrome in children?

Answer 4

1. IgA nephropathy
2. Post-streptococcal glomerulonephritis (PSGN)
3. Henoch–Schönlein purpura (HSP)

Question 5

What commonly causes nephritic syndrome in adults?

Answer 5

1. Goodpasture syndrome
2. SLE
3. Rapidly progressive glomerulonephritis

Question 6

What is the pathophysiology of nephritic syndrome?

Answer 6

The inflammatory processes in the glomerulus cause the capillaries to swell and the pores between podocytes become large enough that inappropriate contents in the blood plasma (i.e. red blood cells, protein, etc.) will begin to spill into the urine

Question 7

What is the relationship between the GFR and nephritic syndrome?

Answer 7

The inflammatory processes in the glomerulus cause a decrease in glomerular filtration rate (GFR) and, if left untreated over time, will eventually produce uraemic symptoms and retention of sodium and water in the body, leading to both edema and hypertension

Question 8

How does nephritic syndrome present?

Answer 8

Nephritic syndrome is characterised by:

1. Haematuria
2. Hypertension
3. Decreased urine output
4. Red blood cell casts
5. Pyuria
6. Proteinuria
7. Oedema

Question 9

How is nephritic syndrome diagnosed?

Answer 9

1. Physical examination for oedema, HTN and crackles

2. Investigations for electrolytes, creatinine, blood urea nitrogen and urinalysis

Question 10

How is nephritic syndrome managed?

Answer 10

Control elevated blood pressures and reduce active inflammation in the kidney itself

Bed rest, fluid restriction, low sodium, diuretics

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