Nephritic syndrome

Specialty of Nephrology

What is nephritic syndrome?      

Nephritic syndrome refers to a collection of symptoms which occur as a result of kidney inflammation.

Nephritic syndrome can be diagnosed when the following symptoms appear:

  • Oedemas; fluid accumulation in the legs and face
  • Haematuria; which is the presence of blood in the urine
  • High blood pressure

If these symptoms are present and there is a decreased kidney function and a loss of protein in the urine, this can indicate nephritic syndrome.       

Syndrome prognosis  

Syndrome prognosis will depend on what is causing the nephritic syndrome. In cases of improvement, symptoms such as oedema, cough, and blood pressure will lessen in one or two weeks. Urine tests may take several months to be normal. Children tend to have a better prognosis, and in many cases make a full recovery. There are few cases in which complications arise that lead to chronic glomerulonephritis or chronic kidney disease. In adults, recovery takes longer and is more complicated. In some cases, acute nephritic syndrome may recur leading to end-stage renal disease that requires dialysis or a kidney transplant.     

What are the symptoms?    

Common symptoms include:

  • Blood in the urine
  • Decreased urine volume
  • Legs, face, sockets, arms, feet, hands, and abdominal swelling
  • High blood pressure.

Other symptoms are:

  • Blurred vision, this is normally due to a ruptured retinal blood vessel.
  • Phlegmy cough, with pink or foamy sputum, due to fluid in the lungs. 
  • Difficulty breathing due to fluid in the lungs.
  • Inability to perform daily tasks, feeling drowsy, confused, and having aches and pains.

Other symptoms may include kidney failure or chronic kidney disease.  

Medical tests

Through diagnostic tests, the specialist can identify the following signs and symptoms:

  • High blood pressure
  • Abnormal heart and pulmonary sounds.
  • Fluid retention symptoms such as; legs, arms, face, and abdominal swelling.
  • Dilated neck veins. 

Medical tests may include:

  • Measuring electrolytes in the blood
  • Calculate blood urea nitrogen
  • Measure creatinine
  • Do a creatinine clearance
  • Potassium test
  • Identify possible protein in the urine
  • Urine analysis.   

A renal biopsy may show an inflammatory lesion and white blood cells in the glomeruli. This can be due to several diseases.    

What causes it?

Nephritic syndrome is caused by an immune system response to an infection or disease.

The most common causes in children and teens include:  

  • Haemolytic-uremic syndrome, a disorder that appears after a digestive tract infection produces harmful substances that kill red blood cells and affect the kidneys.
  • Schönlein-Henoch purpura, a disorder that includes gastrointestinal problems and glomerulonephritis.
  • Immunoglobulin A nephropathy, disorder in which IgA antibodies are stored in the kidney tissue.
  • Post-streptococcal glomerulonephritis, disorder that affects the kidney and appears after an infection with strains of streptococcus. 

The most common causes in adults include:    

  • Abdominal abscesses.
  • Goodpasture syndrome (GPS), a rare immune system disease that attacks the glomerulus.
  • Hepatitis B or C.
  • Endocarditis, inflammation of the inner lining of the heart chambers and valves, caused by a bacterial infection or fungi.
  • Membranoproliferative glomerulonephritis (MPGN), a disorder that affects the kidneys.
  • Glomerulonephritis with crescents, a type of glomerulonephritis that causes a rapid loss of kidney function.
  • Lupus nephritis, a kidney complication of systemic lupus erythematosus.
  • Vasculitis, inflammation of blood vessels.
  • Viral diseases such as; mononucleosis (glandular fever), measles, or mumps.

How can it be prevented?

There is no known way to prevent the syndrome, but correctly treating it and any infections can greatly improve the patient’s quality of life.  

In most cases, the syndrome cannot be avoided, but treatment will help the disease and any infections, improve quality of life, and reduce the risk of complications.

What is the treatment?

Treatment aims to reduce kidney swelling and control high blood pressure. The patient may need to be hospitalised to get diagnosed and treated. The specialist will likely recommend the following: 

  • Bed rest
  • Follow a low in salt and potassium diet and avoid liquids with meals
  • High blood pressure medications or diuretics  
  • Some cases may require kidney dialysis.  

What specialist should I see?

The specialist who treats nephritic syndrome is a nephrologist. A nephrologist studies the kidneys, their functions and diseases. Their aim is to diagnose and treat kidney diseases.   

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