Gland, pneumonia treatment, nephritis, nephrotic syndrome, and many others. Generally, the prognosis of nephritic syndrome in children is better than it is in adults. The nephrotic syndrome annals of internal medicine. Nephritic syndrome is characterized by glomerular damage leading to hematuria, pyuria, water retention, and subsequent hypertension and edema. Difference between glomerulonephritis and nephrotic. Nephritic syndrome knowledge for medical students and. Nephrotic syndrome presents clinically with massive proteinuria and hypoalbuminemia, accompanied by variable forms of edema, hyperlipidemia, and lipiduria, all as a result of increased glomerular permeability 1, and it can be associated with nephritic syndrome when some or all of its clinical concomitant manifestations arterial hypertension. The presence of these syndromes in the neonate can cause significant morbidity and mortality.
Haematuria can be frank haematuria or microscopic oedema to a lesser extent compared to nephrotic syndrome reduced. Key difference glomerulonephritis vs nephrotic syndrome a syndrome is a combination of medical problems that show the existence of a particular disease or mental condition. Associate editor national journal of emergency medicine. In nephritic syndrome, there is some proteinuria and edema, but its not nearly as severe as in nephrotic syndrome. Difference between nephrotic syndrome and nephritic syndrome. Nephroticrange proteinuria is the presence of 3 g or more per day of protein in the urine or the presence of 2 g of protein per gram of urine creatinine on a single spot urine collection.
Nov 09, 2017 the classical nephritic syndrome has a sudden onset days weeks and the main cause is post streptococcal glomerulonephritis. Nephrotic syndrome may affect adults and children of both sexes and of any race. Nephrotic syndrome is the combination of nephroticrange proteinuria with a low serum albumin level and edema. It can be caused by a variety of conditions including autoimmune, hereditary, and infectious diseases. Age plays an important role in identifying the cause of nephritic syndrome. Objectives define nephrotic syndrome pathogenesis of oedema causes of nephrotic syndrome in children minimal change disease. It contains different signs or indications of the nephritis which a diseases of the kidneys. Which of the two patterns of nephritic or nephrotic syndrome would you expect to see in mpgn. Ppt acute nephritic syndrome powerpoint presentation. The blood protein albumin makes up much of the protein that is lost, though many other important proteins are also lost in nephrotic syndrome.
Jun 10, 2009 in nephritic syndrome, there is some proteinuria and edema, but its not nearly as severe as in nephrotic syndrome. Nephrotic syndrome versus nephritic syndrome current. According to the cdc, nephritisnephrosis nephritic syndrome was the 9th leading cause of death in the united states in 2017. Nephrotic syndrome poc nephritic syndrome edema hypoalbuminemia proteinuria hypercholesterolemia not essential characteristic htn mild edema oliguria azotemia high jvp dark urine any inflammation cause proteinuria then edema then hypovolemia then more hypoalbuminemia and hyperlipidemia mechanism 2 immunological disorder causing thickening of bm 1. Nps and pas have provided great feedback on pneumonia treatment and liver. Chronic gn is slowly progressive and is associated with hypertension and gradual loss of kidney function.
Thus, quick diagnosis and immediate initiation of immunosuppressive therapy are required to prevent irreversible kidney. First deciding between nephritic and nephrotic syndrome is a useful starting point for your differential diagnosis. Acute nephritic syndrome is the property of its rightful owner. It often occurs in the glomerulus, where it is called glomerulonephritis. Difference between nephrotic and nephritic syndrome. Nephrotic syndrome is a collection of symptoms due to kidney damage. Rapid and efficient diagnosis of diseases presenting as acute glomerulonephritis andor nephrotic syndrome is critical for early and appropriate therapy aimed at preservation of renal function. Sep 30, 2012 nephrotic syndrome presents clinically with massive proteinuria and hypoalbuminemia, accompanied by variable forms of edema, hyperlipidemia, and lipiduria, all as a result of increased glomerular permeability 1, and it can be associated with nephritic syndrome when some or all of its clinical concomitant manifestations arterial hypertension. On a superficial level, it is safe to say that nephritic syndrome is characterized by a loss of blood in the urine from the damaged renal epithelia, whereas in nephrotic syndrome, loss of proteins is very common in the urine analysis. Nephrotic syndrome is a condition where the kidneys leak protein from the blood into the urine. The differences between nephrotic and nephritic syndrome are easily forgotten. Although there may be overlap in clinical presentation, and some patients present with clinical features.
This includes protein in the urine, low blood albumin levels, high blood lipids, and significant swelling. Regardless of origin, the basic condition is characterized by hematuria, mild nonnephrotic, ie less than 3. Diagnosis and management charles kodner, md, university of louisville school of medicine, louisville, kentucky i n nephrotic syndrome, a variety of disorders cause. At the most basic level, remember that nephrotic syndrome involves the loss of a lot of protein, whereas nephritic syndrome involves the loss of a lot of blood. Thus, to say this book is about the nephrotic syndrome is about as accurate as describing the bible as a book about an apple tree. No, its the nephrotic presentation of a disease which usually presents as a nephritic syndrome. Jul 19, 2017 nephrotic range proteinuria is the presence of 3 g or more per day of protein in the urine or the presence of 2 g of protein per gram of urine creatinine on a single spot urine collection.
Difference between glomerulonephritis and nephrotic syndrome. Er with fever, abdominal pain, and has had puffy eyes for the past 2 days. Nephrotic syndrome is a condition involving the loss of significant volumes of protein via the kidneys proteinuria which results in. This is video 1 of 1 on nephrotic vs nephritic syndromes.
Differential diagnosis of nephrotic and nephritic syndrome. Just like nephritic syndrome, this one also has following features. The thing with nephritic syndrome is that the lesions causing it all have increased cellularity within the glomeruli, accompanied by a leukocytic infiltrate hence the suffix itic. Laboratory findings include hematuria, proteinuria apr 29, 2016 nephrotic vs nephritic syndrome 1. By doing so, i hope that im residents will enjoy medicine, and medical students will find interest in internal medicine. Nephritic syndrome is a syndrome comprising signs of nephritis, which is kidney disease involving inflammation. Comprehensive medical revision notes discussing nephrotic vs nephritic syndrome, including symptoms, signs, investigations and management strategies. Nephrotic syndrome may appear as a primary idiopathic renal disease or occur in association with any of a number of systemic conditions and hereditary diseases. Learn vocabulary, terms, and more with flashcards, games, and other study tools. In a nephrotic syndrome, a group of manifestations occur, such as protein in the urine, edema, low count of albumin in the blood, and lastly too much lipids or fats circulating in the blood. Steroids have been used widely since the early 1970s for the treatment of adult.
The classical nephritic syndrome has a sudden onset days weeks and the main cause is post streptococcal glomerulonephritis. Other symptoms may include weight gain, feeling tired, and foamy urine. However, there are differences between nephrotic syndrome and nephritic syndrome in the clinical features. Nephritic syndrome consists of a combination of some or all of the following signs. The major determinant of whether the patient presents with gn and an active urine sediment nephritic syndrome or with proteinuria nephrotic syndrome and little or no hematuria is the. Nephrotic syndrome vs nephritic syndrome explained nephritic vs nephrotic. Nephrotic syndrome is also associated with clinically important complications related to urinary loss of proteins other than albumin. Nov 07, 20 nephrotic vs nephritic syndrome nephrotic and nephritic syndromes are common childhood conditions presenting with oedema and proteinuria. Difference between nephrotic and nephritic syndrome compare. What is the difference between nephritic and nephrotic. In the united states, diabetes mellitus is the most common cause of nephrotic syndrome.
The most common primary glomerular diseases include membranous nephropathy, focal segmental glomerular sclerosis, minimal change, and membranoproliferative glomerulonephritis mpgn. Although this text is titled the nephrotic syndrome, it is about the glomerulopathies, all of them, whether nephritic, nephrotic, or neither. The majority of cases of acute nephritic syndrome have a postinfectious etiology, most commonly following infection with group a. Nephrotic vs nephritic syndrome nephrotic and nephritic syndromes are common childhood conditions presenting with oedema and proteinuria. Difference between nephrotic syndrome and nephritic. Approximately onethird of patients with both type 1 and type 2 diabetes mellitus of at least a 25year duration will develop nephrotic syndrome, predictably leading to renal failure. Oct 26, 2010 differential diagnosis of nephrotic and nephritic syndrome. Apr 01, 2015 in a nephrotic syndrome, a group of manifestations occur, such as protein in the urine, edema, low count of albumin in the blood, and lastly too much lipids or fats circulating in the blood.
Nephritic syndrome an overview sciencedirect topics. Nephrotic syndrome investigations quantify how severe nephrotic syndrome. Nephrotic syndrome with a nephritic component associated with. One of the defining features used to determine the difference between nephritic and nephrotic syndromes is the amount of protein in the urine. Nephrotic syndrome ns is a welldefined syndrome mainly characterized by the presence of proteinuria which is more than or equal to 3. Edema may also be present, although it is not nearly as severe as in nephrotic syndrome. Nephrotic syndrome poc nephritic syndrome edema hypoalbuminemia proteinuria hypercholesterolemia not essential characteristic htn mild edema oliguria azotemia high jvp dark urine any inflammation cause proteinuria then edema then hypovolemia then more hypoalbuminemia and hyperlipidemia mechanism 2 immunological disorder causing thickening. Nephrotic syndrome vs nephritic syndrome explained nephritic vs. Mar 23, 2017 nephrotic syndrome vs nephritic syndrome. As i have already told you that there is a lot of loss of blood in the nephritic syndrome while in nephrotic syndrome, there is loss of proteins and this is the most basic difference between the two. Nephrotic vs nephritic syndrome faculty of medicine. Although primary ns is a relatively rare condition, anyone can get it. Nephritic syndrome is also known as glomerulonephritis and it is characterized by edema, increased blood pressure and haematuria red blood cells in urine.
Feb 16, 2009 also i think it is misleading to assoc. Regardless of origin, the basic condition is characterized by hematuria, mild non nephrotic, ie less than 3. What is the difference between nephritic and nephrotic syndrome. This is because each is associated with a particular subset of diseases. Nephritic syndrome is defined by hematuria, variable degrees of proteinuria, usually dysmorphic red blood cells rbcs, and often rbc casts on microscopic examination of urinary sediment. This video gives a brief explanation of the etiology, pathophysiology, presentation, and management of both nephrotic and nephritic syndromes. Acute nephritic syndrome is characterized by a sudden onset of macroscopic hematuria accompanied by hypertension, oliguria, edema, and varying degrees of renal insufficiency due to acute glomerular injury. Urine samples are taken to diagnose people suspected of having nephrotic syndrome. It can be caused nephritic syndrome knowledge for medical students and physicians. Nephrotic syndrome can present as asymptomatic proteinuria, but the most common symptom and sign at presentation is edema. Nephritic syndrome knowledge for medical students and physicians. Because nephritic syndrome is a syndrome and not a disease, the prognosis depends on the underlying cause.
Children who have evidence of glomerular bleeding may have nephritic syndrome secondary to glomerulonephritis, and those with heavy proteinuria are likely to have nephrotic syndrome. Feb 22, 2016 this video gives a brief explanation of the etiology, pathophysiology, presentation, and management of both nephrotic and nephritic syndromes. Proteinuria nephrotic and nephritic syndrome im reference. Nephrotic vs nephritic syndrome proteinuria, hematuria, casts. Later the patient developed ht and renal dysfunction, and will fall in the syndromic diagnosis of nephritic syndrome the whole exercise of this case was to tell you that the classification of glomerular disease is not perfect. Nephritic syndrome is a disease of kidney structure element glomeruli. The sole purpose of this website is to help internal medicine residents, medical students, and attendings to learn and teach medicine at its best.
Nephrotic syndrome is diagnosed when large amounts of protein are found in the urine. Nephrotic and nephritic syndrome in the newborn clinics in. Nephrotic syndrome histopathological process or clinical entity. Causes of nephritic syndrome include postinfectious glomerulonephritis, iga nephropathy berger disease, thin basement membrane disease, and rapidly progressive glomerulonephritis. Nephrotic syndrome with a nephritic component associated.
Glomerular diseases knowledge for medical students and. Nephrotic or nephritic syndrome can be caused by multiple disease processes. Nephritic syndrome is a condition involving haematuria, mild to moderate proteinuria typically less than 3. Jan 23, 2015 no, its the nephrotic presentation of a disease which usually presents as a nephritic syndrome. Synopsis of nephritic syndrome and membranoproliferative glomerulonephritis mpgn your patient is an 18 yearold woman who is seen for. Nephritic syndrome can present with oliguria, hypertension, and hematuria colacolored urine. Diagnosis and management charles kodner, md, university of louisville school of medicine, louisville, kentucky i n nephrotic syndrome, a. Glomerulonephritis is characterized by inflammation and thinning of the glomerular basement membrane and the occurrence of small pores in the podocytes of the. Complications may include blood clots, infections, and high blood pressure. Minimal change disease is the third most common primary kidney disease in adults with unexplained nephrotic syndrome 10% to 15%. Clinical examination a comprehensive collection of clinical examination osce guides that include stepbystep images of key steps, video demonstrations and pdf mark schemes. Does nephritic or nephrotic pattern of mpgn present in a rapidly or slowly progressive manner. Ns is one of the most common contributors of chronic kidney disease ckd and responsible for 12% of kidney failure in adults and 20% in children.
Overview of nephritic syndrome genitourinary disorders. Nonetheless, age should not be the only factor in defining the etiology of nephritic. In a nephritic syndrome, all of these occur plus there. Edema occurs initially in areas of high intravascular hydrostatic pressure, such as in the feet and ankles, as well as in areas in where tissue hydrostatic pressure is lowest.