What is Nephritic Syndrome?

Nephritic syndrome is a clinical syndrome presented as hematuria, high blood pressure, edema, and decreased urine output [1]. The major underlying pathology is inflammation of the glomerulus. The primary pathology can be in the kidney or it can be caused by a systemic disorder.

 

In nephritic syndrome, the patient's urine contains the sediments of red blood cells, white blood cells, cellular casts, a varying quantity of protein, and a rising serum creatinine [2].

 

 

 

What are the Symptoms of Nephritic Syndrome?

 

The symptoms of Nephritic syndrome are as follows [3]:

• Hematuria (blood in urine)
• Proteinuria (protein in blood
• Dysmorphic red blood cells
• Periorbital and pedal edema
• Hypertension
• Oliguria
• Azotemia
• Elevated serum creatinine
• Malaise (general ill feeling)
• Drowsiness
• Confusion
• Aches
• Pains
• Headache
• Shortness of Breath because of fluid buildup in the lungs
• Cough
• Blurred vision

 

 

 

What are the Causes of Nephritic Syndrome?

Nephritic syndrome is classified as:

1. Acute (serum creatinine rises over many weeks or less)
2. Chronic (renal insufficiency may progress with time)

 

Acute nephritic syndrome is usually caused by an immune response against any bacterial infection or other diseases [4].

 

Some other categories of nephritic syndrome are hemolytic uremic syndrome, Henoch-Schonlein purpura, IgA nephropathy, and post-streptococcal glomerulonephritis.

 

Hemolytic uremic syndrome occurs when an infection in the gastrointestinal tract produces toxic substances that destroy red blood cells and damage the kidney.

 

IgA nephropathy is a condition in which antibodies against igA buildup in the kidney.

 

Henoch-Scholein purpura is a disorder that involves purple spots on the skin. It also causes joint pain and digestive tract problems.

 

Post-streptococcal glomerulonephritis is a kidney disorder that occurs after an infection with certain strains of streptococcus bacteria.

 

Some other causes of nephritic syndrome are abdominal abscesses, hepatitis B or C, and other viral diseases such as infectious mononucleosis, measles, and mumps.

 

Vasculitis, lupus nephritis, endocarditis, and membranoproliferative glomerulonephritis can also cause nephritic syndrome.

 

 

 

What are the Treatment Options for Nephritic Syndrome?

 

The treatment for nephritic syndrome is mainly supportive. The treatment options are as follows:

• Antihypertensive drugs
• Diuretics
• Corticosteroids
• Immuno-modulators
• Antibiotics
• Dialysis

 

Antihypertensive drugs are administered to patients for blood pressure management. Diuretics are given to excrete excess sodium and water from the body.

 

Corticosteroids help reduce the inflammation of the kidney and promote healing. Immunomodulators reduce and block the antigenic effects of the inciting agents.

 

Antibiotics are given to patients with evidence of streptococcal infections. Penicillin and Erythromycin are the best options.

 

If the disease is progressing very rapidly and damaging the kidney, the most suitable treatment option is Dialysis.

 

 

 

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK562240/#:~:text=The%20nephritic%20syndrome%20is%20a,be%20promptly%20diagnosed%20and%20managed.
2. https://www.uptodate.com/contents/glomerular-disease-evaluation-in-children#:~:text=Acute%20nephritic%20syndrome%20%E2%80%93%20An%20acute,Histologic%20examination%20demonstrates%20inflammation.
3. https://www.msdmanuals.com/professional/genitourinary-disorders/glomerular-disorders/overview-of-nephritic-syndrome
4. https://medlineplus.gov/ency/article/000495.htm
5. https://www.ncbi.nlm.nih.gov/books/NBK562240/#:~:text=The%20treatment%20consists%20of%3A,inhibitors%2C%20ARBs%2C%20and%20nifedipine.

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