What is the difference between nephrotic and nephritic syndrome

Nephrotic syndrome generally reflects noninflammatory damage to the glomerular capillary wall. The underlying glomerular disease results in proteinuria, which occurs from alterations in the charge or size selectivity of the glomerular capillary wall.

This increases glomerular permeability to plasma proteins. Albumin is the principal urinary protein lost, but other plasma proteins lost in the urine include hormone-carrying proteins such as vitamin D-binding protein, transferrin, and clotting inhibitors. We do not know how to prevent primary nephrotic syndrome.

Secondary nephrotic syndromes can often be improved and sometimes completely reversed by treating and controlling the underlying disease. Nephrotic syndrome can present with a spectrum of findings ranging from asymptomatic proteinuria to the most common presentation of edema.

Edema occurs initially in areas of high intravascular hydrostatic pressure such as in the feet and ankles as well as in areas in which tissue hydrostatic pressure is lowest such as the periorbital and scrotal areas. If the edema is severe and generalized it can present as anasarca. This ratio approximates the actual hour protein excretion in grams per day per 1. Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'.

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view. Forgot Username? In white patients the most common cause is membranous nephropathy ; in African American patients the most commonly known cause is segmental glomerulosclerosis. Both of these make up around 30 percent of cases. Minimal change disease and immunoglobulin A nephropathy comprise around 15 percent of cases of nephrotic syndrome.

There are several underlying conditions that can lead to nephrotic syndrome with the two most common being type 2 diabetes and lupus. A protein to creatinine ratio can be completed on a single urine sample to diagnose proteinuria. Another key aspect in patients with nephrotic syndrome, is trying to elucidate that underlying cause of the disease. Renal biopsy may be completed in some patients; however, guidelines are controversial as to whether to complete this or not.

Regarding treatment of nephrotic syndrome , one of the most important things is to try to avoid complications that can occur due to nephrotic syndrome. For edema , patients can be started on diuretics , such as furosemide, other loop diuretics, or thiazide diuretics.

Regarding the increased risk of venous thrombosis , each patient should be evaluated independently. Those patients who are at high risk of venous thrombosis could be started on anticoagulation, however, the bleeding risk could outweigh the risk of thrombosis, in which this instance you would not want to start anticoagulation.

Lastly for hyperlipidemia there is insufficient data to recommend starting dyslipidemia medication for isolated hyperlipidemia in patients who have nephrotic syndrome. This article provides a very brief overview of nephrotic and nephritic syndrome , to help you differentiate the two conditions.

Nephrotic syndrome is a condition involving the loss of significant volumes of protein via the kidneys proteinuria which results in hypoalbuminaemia. As a result of hypoalbuminaemia, nephrotic syndrome is associated with oedema due to reduced oncotic pressure , hyperlipidaemia and hypercoagulability. Typical findings on urinalysis in the context of nephrotic syndrome include:. Nephritic syndrome is a condition involving haematuria , mild to moderate proteinuria typically less than 3.

Typical findings on urinalysis in the context of nephritic syndrome include:. Clinical Examination. An Introduction to the Arclight. Eye Drops Overview. Statin Counselling. Prescribing in Renal Impairment. Nephritic syndrome has many potential triggers, therefore, successfully treating it involves identifying the underlying cause. Nephritic syndrome has both acute and chronic forms. Acute, or rapidly-progressing, nephritic syndrome usually comes on suddenly and, because of acute and painful symptoms, seldom goes undetected.

Chronic nephritic syndrome typically progresses slowly and often goes undetected for some time. Nephritic syndrome is the result of inflammation affecting small groups of blood vessels, known as glomeruli, in the kidneys. The inflammation can originate in the kidneys themselves or be the result of infection or injury elsewhere in the body.

Nephritic syndrome can develop as a result of any of the following: [1] [4]. IgA nephropathy is a very common cause of nephritic syndrome. Bacterial infections: Such as methicillin-resistant staphylococcus aureus MRSA , pneumococcal pneumonia , typhoid, infective endocarditis , or secondary syphilis.

Nephritic syndrome following a streptococcal throat infection is fairly common, especially in children. Viral infections: Such as hepatitis B, mumps , measles , chickenpox or glandular fever mononucleosis. Abdominal abscess: A pocket of infected fluid and pus inside the abdominal cavity.

This can be located on or near any organ. Parasitic infections: Such as malaria. As there are many underlying conditions for nephritic syndrome, there are different risk factors, such as recent infections, immune system disorders and genetic disorders. See the sections below for more information on the relationship between nephritic syndrome and glomerulonephritis, and nephritic syndrome and systemic lupus erythematosus.

If you are concerned that you or someone you know may be experiencing nephritic syndrome, you can do a free symptom assessment using the Ada app at any time. Typical symptoms include passing less urine than normal, having blood in the urine and swelling of the feet or face edema.

Other possible symptoms are flank pain, back pain, headache, shortness of breath and symptoms related to the underlying cause, for example a skin rash and joint pain. The symptoms of nephritic syndrome differ, depending on whether the acute or chronic form of the syndrome is present.

Symptoms of acute nephritic syndrome include: [1] [2] [4]. Chronic nephritic syndrome usually presents with fairly mild or even undetectable symptoms, which can include: [2].

In both chronic and acute nephritic syndrome, the urine will usually contain high concentrations of red blood cells, as the blood cells leak out of the damaged glomeruli. If you are concerned that you or someone you love may have nephritic syndrome, you can consult the Ada app for a free symptom assessment.

The diagnosis of nephritic syndrome is typically based on a physical examination of the person and analysis of their urine urinalysis. People with nephritic syndrome tend to have high blood pressure, so a doctor will check this. A doctor will also look for signs of:. A kidney biopsy tissue sample from the kidney may be performed to investigate the cause of the nephritic syndrome.

Because nephritic syndrome is a cluster of symptoms rather than a disease in itself, much of the testing that makes up the diagnosis is aimed at determining what the underlying cause is. Another important element in diagnosis is differential diagnosis, as the illness may be nephrosis rather than nephritis. In examining a person with potential nephritic syndrome, a doctor might carry out the following tests: [1].

Take patient history: A doctor will ask the affected person about the time at which their symptoms began and attempt to determine the point at which the kidneys began to excrete protein into the urine. Check appearance and colour of urine: Urine that is dark in colour may be very concentrated and contain blood. Edema assessment: Edema, or fluid gathering in the tissues, can be a sign that there is not enough protein in the blood and may suggest proteinuria.

Urine dipstick test: A simple form of urinalysis that is used as a quick test for blood and protein in the urine. They will use a dipstick test, in which a test-strip of paper is immersed in a urine sample, to check for blood and protein in the urine.

Urinalysis: A urine sample will be sent to a laboratory to do a precise check for protein levels and red blood cells.

Blood tests: To check levels of electrolytes, creatinine, blood urea nitrogen, immunoglobulins, antibodies, and other substances. It uses only local anesthetic and is done using ultrasound and specialized biopsy needles to remove a small sample of tissue.

Treatment depends on the underlying causes. Medications such as ramipril, benazepril, candesartan, or valsartan are typically used to treat the high blood pressure. Medications will also be administered to reduce inflammation in the kidneys.

Generally, doctors will recommend: [1]. The time it takes to recover from nephritic syndrome varies according to its severity and the underlying cause. Most patients begin to feel better fairly soon, especially if treatment is prompt.