Nephritic syndrome


Nephritic syndrome
Nephritic syndrome
Classification and external resources
ICD-10 N00, N01, N03, N05
ICD-9 580
MedlinePlus 000495
Not to be confused with nephrotic syndrome

Nephritic syndrome (or acute nephritic syndrome)[1] is a collection of signs (known as a syndrome) associated with disorders affecting the kidneys, more specifically glomerular disorders. [2] It is characterized by having small pores in the podocytes of the glomerulus, large enough to permit proteins (proteinuria) and red blood cells (hematuria) to pass into the urine. By contrast, nephrotic syndrome is characterized by only proteins (proteinuria) moving into the urine. Both nephritic syndrome and nephrotic syndrome result in hypoalbuminemia due to protein albumin moving from the blood to the urine.

Hematuria can be caused by bleeding anywhere in the urinary tract, but if the RBCs are trapped in urinary casts, it is more likely that the bleeding originated in the nephron, and nephritic syndrome becomes more probable.

It is usually distinguished from nephrotic syndrome, but sometimes the two are described as associated in a minority of cases (occasionally--and confusingly--referred to as "nephritic/nephrotic", though this is considered a progression of a nephritic syndrome, and categorically not a nephrotic syndrome).[3] Some conditions can cause either syndrome, and both syndromes can have a similar appearance upon biopsy. Neither term represents a definitive diagnosis, but both terms can be useful in the early stages of a differential diagnosis.

Contents

Signs and symptoms

Nephritic syndrome is characterized by;

and variable renal insufficiency, with;

The main features are hypertension and RBC casts. The proteinuria in nephritic syndrome is not usually severe, but may occasionally be heavy enough to be in the range usually found in nephrotic syndrome.

Mnemonic: PHARAOH = Proteinuria, Hematuria, Azotemia, RBC casts, Anti-strep titres (if post-strep), Oliguria, Hypertension

Diagnosis

Nephritic syndrome is not a specific diagnosis. It is a clinical syndrome and characterized by the above signs.

An anti-streptolysin O titre (or ASOT) is typically done to test for exposure to streptococci. This test however has very poor specificity.

Pathophysiology

The exact pathophysiology is dependent on the specific diagnosis. However, the common features are an inflammation of the glomeruli, leading to salt and water retention (causing hypertension) and a reduction in the kidney function.

Differential diagnosis

The two classic diagnoses of nephritic syndrome are:

Nephritic syndrome causes are usually grouped into 'focal proliferative' and 'diffuse proliferative' on the basis of histology (obtained by a renal biopsy).

Focal proliferative

Diffuse proliferative

Treatment

Treatment is dependent on the underlying etiology (cause) and the degree of kidney dysfunction.

Prognosis

Because nephritic syndrome is not a disease, just a collection of symptoms, the prognosis depends on the underlying etiology.

References

External links


Wikimedia Foundation. 2010.

Look at other dictionaries:

  • acute nephritic syndrome — the sudden onset of hematuria, proteinuria, diminished urine production, azotemia, hypertension, and edema; the clinical manifestation of acute glomerulonephritis …   Medical dictionary

  • syndrome — The aggregate of symptoms and signs associated with any morbid process, and constituting together the picture of the disease. SEE ALSO: disease. [G. s., a running together, tumultuous concourse; (in med.) a concurrence of symptoms, fr. syn,… …   Medical dictionary

  • Nephrotic syndrome — Classification and external resources Histopathological image of diabetic glomerulosclerosis with nephrotic syndrome. H E stain. ICD 10 N …   Wikipedia

  • Goodpasture's syndrome — Infobox Disease Name = PAGENAME Caption = DiseasesDB = 5363 ICD10 = ICD10|M|31|0|m|30 (ILDS M31.010) ICD9 = ICD9|446.21 ICDO = OMIM = 233450 MedlinePlus = eMedicineSubj = med eMedicineTopic = 923 eMedicine mult = eMedicine2|ped|888 MeshID =… …   Wikipedia

  • Fanconi syndrome — Not to be confused with Fanconi anemia. Fanconi syndrome Classification and external resources ICD 10 E72.0 ICD 9 …   Wikipedia

  • Nutcracker syndrome — Classification and external resources The nutcracker syndrome results from compression of the left renal vein between the aorta and the superior mesenteric artery. DiseasesDB …   Wikipedia

  • Ovarian vein syndrome — Relation of artery to ureter In medicine, ovarian vein syndrome is a rare (possibly not uncommon, certainly under diagnosed) condition in which a dilated ovarian vein compresses the ureter (the tube that brings the urine from the kidney to the… …   Wikipedia

  • Glomerulonephritis — Infobox Disease Name = PAGENAME Caption = DiseasesDB = 5245 ICD10 = N00, N01, N03, N18 ICD9 = ICD9|580 ICD9|582 ICDO = OMIM = MedlinePlus = eMedicineSubj = eMedicineTopic = MeshID = D005921 Glomerulonephritis, also known as glomerular nephritis,… …   Wikipedia

  • Rapidly progressive glomerulonephritis — Classification and external resources Histopathological image of crescentic glomerulonephritis in a patient with MPO ANCA positive rapid progressive glomerulonephritis. Hematoxylin eosin stain …   Wikipedia

  • Urinary casts — are cylindrical aggregations of particulate matter that form in the distal nephron, dislodge, and eventually pass into the urine. They form via precipitation of Tamm Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also …   Wikipedia


Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”

We are using cookies for the best presentation of our site. Continuing to use this site, you agree with this.