Nephritic syndrome

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Nephritic syndrome Classification and external resources
ICD-10	N00., N01., N03., N05.
ICD-9	580

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Overview

Not to be confused with nephrotic syndrome

Nephritic syndrome is a collection of signs (known as a syndrome) associated with disorders affecting the kidneys, more specifically glomerular disorders.

Signs and symptoms

Nephritic syndrome is characterized by;

• proteinuria (protein in the urine)
• hematuria (blood in the urine), with red blood cell (RBC) casts present in the urine
• hypertension (high blood pressure)

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-infectious glomerulonephritis - also sometimes called post-streptococcal glomerulonephritis as the streptococcus is the most common cause and at one time was thought to be the only cause.
• 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).

Prognosis

Prognosis depends on the underlying etiology.

External links

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

References

v • d • e Urinary system - Pathology - Nephrology (N00-N39, 580-599)
Diseases of the glomerulus	Glomerulonephritis - Focal segmental glomerulosclerosis - Membranoproliferative glomerulonephritis - Membranous glomerulonephritis - Nephritic syndrome - Post-streptococcal glomerulonephritis - Nephrotic syndrome (Minimal change disease) - IgA nephropathy - Lupus nephritis - Diabetic nephropathy - Rapidly progressive glomerulonephritis
Tubulointerstitial diseases of the kidney	Interstitial nephritis - Pyelonephritis - Hydronephrosis - Pyonephrosis - Balkan nephropathy - Reflux nephropathy
Renal failure	Acute renal failure (Acute tubular necrosis) - Chronic renal failure
Urolithiasis	Kidney stone - Renal colic
Diseases of the renal tubule and other disorders of kidney and ureter	Renal osteodystrophy - Nephrogenic diabetes insipidus - Renal tubular acidosis - Nephroptosis - Ureterocele - Abderhalden-Kaufmann-Lignac syndrome - Gitelman syndrome
Other diseases and disorders of urinary system	urinary bladder: Cystitis (Interstitial cystitis, Trigonitis) - Neurogenic bladder - Vesicointestinal fistula urethra: Urethritis (Non-gonococcal urethritis) - Urethral syndrome - Urethral stricture Urinary tract infection
Tumors of the kidney	Renal cell carcinoma - Wilms' tumor (children)
See also congenital conditions (Q60-Q64, 753)

v • d • e WikiDoc Research Resources for Nephritic syndrome (Click show to right to view)
Articles on Nephritic syndrome	Most recent articles on Nephritic syndrome • Most cited articles on Nephritic syndrome • Review articles on Nephritic syndrome • Articles on Nephritic syndrome in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Nephritic syndrome	Powerpoint slides on Nephritic syndrome • Images of Nephritic syndrome • Photos of Nephritic syndrome • Podcasts & MP3s on Nephritic syndrome • Videos on Nephritic syndrome
Evidence Based Medicine Regarding Nephritic syndrome	Cochrane Collaboration on Nephritic syndrome • Bandolier on Nephritic syndrome • TRIP on Nephritic syndrome
Cost Effectiveness of Nephritic syndrome	Cost Effectiveness of Nephritic syndrome
Clinical Trials Involving Nephritic syndrome	Ongoing Trials on Nephritic syndrome at Clinical Trials.gov • Trial results on Nephritic syndrome • Clinical Trials on Nephritic syndrome at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Nephritic syndrome	US National Guidelines Clearinghouse on Nephritic syndrome • NICE Guidance on Nephritic syndrome • NHS PRODIGY Guidance • FDA on Nephritic syndrome • CDC on Nephritic syndrome
Textbook Information on Nephritic syndrome	Books and Textbook Information on Nephritic syndrome
Pharmacology Resources on Nephritic syndrome	Dosing of Nephritic syndrome • Drug interactions with Nephritic syndrome • Side effects of Nephritic syndrome • Allergic reactions to Nephritic syndrome • Overdose information on Nephritic syndrome • Carcinogenicity information on Nephritic syndrome • Nephritic syndrome in pregnancy • Pharmacokinetics of Nephritic syndrome •
Genetics, Pharmacogenomics, and Proteinomics of Nephritic syndrome	Genetics of Nephritic syndrome • Pharmacogenomics of Nephritic syndrome • Proteomics of Nephritic syndrome
Newstories on Nephritic syndrome	Nephritic syndrome in the news • Be alerted to news on Nephritic syndrome • News trends on Nephritic syndrome
Commentary on Nephritic syndrome	Blogs on Nephritic syndrome
Patient Resources on Nephritic syndrome	Patient resources on Nephritic syndrome • Discussion groups on Nephritic syndrome • Patient Handouts on Nephritic syndrome • Directions to Hospitals Treating Nephritic syndrome • Risk calculators and risk factors for Nephritic syndrome
Healthcare Provider Resources on Nephritic syndrome	Symptoms of Nephritic syndrome • Causes & Risk Factors for Nephritic syndrome • Diagnostic studies for Nephritic syndrome • Treatment of Nephritic syndrome
Continuing Medical Education (CME) Programs on Nephritic syndrome	CME Programs on Nephritic syndrome
International Resources on Nephritic syndrome	Nephritic syndrome en Espanol • Nephritic syndrome en Francais
Business Resources on Nephritic syndrome	Nephritic syndrome in the Marketplace • Patents on Nephritic syndrome
Informatics Resources on Nephritic syndrome	List of terms related to Nephritic syndrome

fr:Syndrome néphritiquesv:Nefritiskt syndrom

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .