Nephrotic Syndrome Vs Nephritic Syndrome Flashcards
What is the presentation of nephritic syndrome?
Proteinuria (<3.5g/day)
Hematuria with acanthocytes
RBC casts in urine (collection of abnormal RBC’s that form in the renal tubule visible on urine microscopy)
Mild to moderate oedema
Oliguria (small amounts of urine)
Azotemia (increase in level of nitrogenous waste eg urea and creatinine)
Hypertrension
Sterile Pyuria (presence of leukocyturia)
What is the presentation of nephrotic syndrome?
Heavy proteinuria (>3.5g/day)
Hypoalbuminemia
Generalised oedema
Hyperlipidemia and fatty casts in urine
Hypertension
Increased risk of thromboemobolism (via loss of antithrombin 3)
Increased risk of infection (due to loss of IgG and tissue oedema which compromises the local blood supply and immune response)
What are the causes of nephritic syndrome?
Poststreptococcal glomerulonephritis
IgA nephropathy (Berger disease)
Granulomatosis with polyangiitis
Microscopic polyangiitis
Eosinophilic granulomatosis with polyangiitis
Goodpasture syndrome (anti-GBM disease)
Alport syndrome (hereditary nephritis)
Thin basement membrane disease
Rapidly progressive glomerulonephritis (RPGN)
Lupus nephritis
Most common causes of nephritic-nephrotic syndrome:
Membranoproliferative glomerulonephritis
Diffuse proliferative glomerulonephritis
What are the causes of nephrotic syndrome?
Due to primary or secondary podocyte damage
Minimal change disease
Focal segmental glomerulosclerosis
Membranous nephropathy
Due to secondary podocyte damage
Diabetic nephropathy
Lupus nephritis
What is the pathophysiology behind nephritic syndrome?
Inflammatory response within glomeruli → GBM disruption → loss of renally excreted RBCs (acanthocytes) and ↓ GFR → hematuria, oliguria, azotemia, and ↑ renin → edema and hypertension
What is the pathophysiology behind nephrotic syndrome?
Damage to podocytes → structural damage of glomerular filtration barrier → massive renal loss of protein
