Nephrotic vs nephritic syndrome

Question 1

What are the characteristic features of nephrotic syndrome ?

Answer 1

• Proteinuria > 3 g/day (mostly albumin, also globulins)
• Hypoalbuminaemia (<30)
• Oedema
• Hypercholesterolaemia
• Usually normal renal function

Question 2

What are the characteristic features of nephritic syndrome ?

Answer 2

Acute Renal Failure or AKI

Oliguria – pass less urine

Oedema/ Fluid retention – drinking more than peeing out

Hypertension – fluid retention pushes BP up

Active urinary sediment (haematuria) - RBC’s, RBC & Granular Casts

Question 3

What are the complications of nephrotic syndrome ?

Answer 3

• Infections
• Renal vein thrombosis – could get rapid decline in function of kidney due to thromboses cutting off blood supply to kidney
• PE/DVT
• Volume depletion (overaggressive use of diuretics) - may lead to ARF (pre-renal)
• Vit D deficiency

Question 4

Whats the treatment for nephrotic sydrome ?

Answer 4

• Fluid restriction
• Salt restriction
• Diuretics
• ACE Inhibitors/ ARBs
• ? Anticoagulation - e.g. warfarin
• IV Albumin (only if volume deplete)