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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]

Contents 1 Signs and symptoms 2 Diagnosis 3 Pathophysiology 4 Differential diagnosis 4.1 Focal proliferative 4.2 Diffuse proliferative 5 Treatment 6 Prognosis 7 References 8 External links

Signs and symptoms

Nephritic syndrome is characterized by;

• hematuria (blood in the urine), with red blood cell (RBC) casts present in the urine
• proteinuria (protein in the urine) - small amounts of protein are lost in the urine, but this is usually trivial
• hypertension (high blood pressure)- mild
• ureamia - due to retention of waste products

and variable renal insufficiency, with;

• azotemia (elevated blood nitrogen)
• oliguria (low urine output <400 mL/day)

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: PHAROH = Proteinuria, Hematuria, Azotemia, RBC casts, 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.

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 and a reduction in the kidney function.

Differential diagnosis

The two classic diagnoses of nephritic syndrome are:

• post-streptococcal glomerulonephritis
• crescentic glomerulonephritis

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

Focal proliferative

• IgA nephropathy
• chronic liver failure
• Celiac sprue
• dermatitis herpetiformis
• Henoch-Schoenlein purpura
• Alport syndrome
• SLE

Diffuse proliferative

• focal glomerulosclerosis
• membranoproliferative glomerulonephritis (malaria, hepatitis B, hepatitis C, chronic infection, sickle-cell disease, SLE, hemolytic uremic syndrome/thrombotic thrombocytopenic purpura)
• cryoglobulinemia
• SLE
• rapidly progressing glomerulonephritis (RPGNs) - several.

Treatment

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

Prognosis

Prognosis depends on the underlying etiology.

References

External links

• Acute nephritic syndrome - medlineplus.org
• Nephritic syndrome - A to Z topics.
• Nephritic syndrome - Merck Manual.

v • d • e Urinary system - Pathology - Urologic disease (N00-N39, 580-599) Abdominal Kidney/ nephropathy Glomerulus Nephritis/ glomerulonephritis by structure: Membranoproliferative glomerulonephritis - Membranous glomerulonephritis/Membranous nephritis - IgA nephropathy/glomerulonephritis by disease: Post-streptococcal glomerulonephritis - Lupus nephritis other: Rapidly progressive glomerulonephritis - Nephritic syndrome Nephrosis/ noninflammatory Glomerulosclerosis (Focal segmental glomerulosclerosis, Diabetic nephropathy/glomerulosclerosis) - Nephrotic syndrome (Minimal change disease) - Familial renal amyloidosis Tubulointerstitial/ Renal tubule Interstitial nephritis (Pyelonephritis, Danubian endemic familial nephropathy) Uropathy (Obstructive uropathy, Hydronephrosis, Pyonephrosis) Inborn errors of renal tubular transport (Renal tubular acidosis, Gitelman syndrome) Reflux nephropathy - Nephrogenic diabetes insipidus - Renal papillary necrosis - Analgesic nephropathy Acute tubular necrosis Both/either Renal failure Acute renal failure - Chronic renal failure Vascular Renal artery stenosis - Hypertensive nephropathy - Renovascular hypertension Other Renal osteodystrophy - Nephroptosis - Abderhalden-Kaufmann-Lignac syndrome Ureter Ureteritis - Ureterocele - Megaureter Pelvic Bladder Cystitis (Interstitial cystitis, Trigonitis) - Neurogenic bladder - Vesicointestinal fistula - Vesicoureteral reflux Urethra Urethritis (Non-gonococcal urethritis) - Urethral syndrome - Urethral stricture Other/general Urinary tract infection - Retroperitoneal fibrosis - Urolithiasis (Kidney stone, Renal colic) See also congenital, neoplasia, symptoms/signs

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