Nephritic syndrome and nephrotic syndrome Prepared grope 16 from medical faculty 4

Nephritic syndrome is the name given to a collection of different signs and symptoms that occur as a result of inflammation in the kidneys. This inflammation causes the kidneys to work less effectively. It also causes protein and red blood cells to leak from the bloodstream into the urine. Nephrotic syndrome is a kidney disorder that causes your body to excrete too much protein in your urine.

ETIOLOGY & PATHOGENESIS

Nephritic syndrome is the result of inflammation affecting small groups of blood vessels, known as glomeruli, in the kidneys. As the glomeruli are the kidneys main filter units, this inflammation disrupts the kidneys ability to adequately filter blood. The inflammation can originate in the kidneys themselves or be the result of infection or injury elsewhere in the body. It can occur in people of any age, including children.

Bacterial infections Viral infections Multisystem systemic/inflammatory diseases Abdominal abscess: Parasitic infections Nephritic syndrome can develop as a result of any of the following: primary glomerular diseases: such as iga nephropathy (bergers disease) or membranoproliferative glomerulonephritis. Iga nephropathy is a very common cause of nephritic syndrome. Bacterial infections: such as methicillin-resistant staphylococcus aureus (MRSA), pneumococcal pneumonia, typhoid, infective endocarditis, or secondary syphilis. Nephritic syndrome following a streptococcal throat infection is fairly common, especially in children. Viral infections: such as hepatitis B, mumps, measles, chickenpox or glandular fever (mononucleosis). Multisystem systemic/inflammatory diseases: such as vasculitis, goodpastures syndrome, granulomatosis with polyangiitis, henoch- schönlein purpura, or lupus (systemic lupus erythematosus). Abdominal abscess: A pocket of infected fluid and pus inside the abdominal cavity. This can be located on or near any organ. Parasitic infections: such as malaria.

Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood. Nephrotic syndrome – associated diseases Primary causes Minimal change glomerulonephritis Focal segmental glomerulosclerosis Membranous glomerulonephritis Secondary causes Sle Hep B and C HIV Diabetes mellitus Malignancy

Methods of diagnostics

1) Taking anamnesis, 2) Kidney ultrasound, 3) Physical examination, 4) CT, 5) Blood test. Urine test for total protein in urine urine concentration urine red blood cells (RBCs) urine osmolality

Clinical picture

Methods of diagnostics for nephritic syndrome include: Taking anamnesis Physical examination Kidney biopsy Urinalisys Blood tests

Signs and symptoms of nephrotic syndrome include: Severe swelling (edema), particularly around your eyes and in your ankles and feet Foamy urine, which may be caused by excess protein in your urine Weight gain due to excess fluid retention Fatigue Loss of appetite

Symptoms of nephrotic syndrome : Edema, often showing first as facial puffiness in the morning Hematuria: blood in the urine, which can color it pink, red or brown Oliguria: producing less urine than usual Hypertension: high blood pressure Fatigue: feeling tired, weak and/or exhausted (almost) constantly Edema can also cause shortness of breath and coughing.

Treatment

Treatment of nephritic syndrome Treatment depends on the underlying causes. Medications (such as ramipril, benazepril, candesartan, or valsartan) are typically used to treat the high blood pressure. Medications will also be administered to reduce inflammation in the kidneys. Generally, doctors will recommend: Bed rest A diet that is restricted in salt, potassium and fluid Medication to control blood pressure, if necessary Medication to reduce inflammation Medication to remove fluids from the body Dialysis to replace kidney function in severe cases The time it takes to recover from nephritic syndrome varies according to its severity and the underlying cause. Most patients begin to feel better fairly soon, especially if treatment is prompt.

Treatment for nephrotic syndrome involves treating any underlying medical condition that may be causing your nephrotic syndrome. Your doctor may also recommend medications that may help control your signs and symptoms or treat complications of nephrotic syndrome. Medications may include: 1) Blood pressure medications. 2) Water pills. 3) Cholesterol-reducing medications. 4) Blood thinners. 5) Immune system-suppressing medications.

Complications

Complications Possible complications of nephrotic syndrome include: Blood clots. High blood cholesterol and elevated blood triglycerides. Poor nutrition. High blood pressure. Acute kidney failure. Chronic kidney disease. Infections.

Lifestyle and home remedies Changes to your diet may help you cope with nephrotic syndrome. Your doctor may refer you to a dietitian to discuss how what you eat can help you cope with the complications of nephrotic syndrome. A dietitian may recommend that you: Choose lean sources of protein Reduce the amount of fat and cholesterol in your diet to help control your blood cholesterol levels Eat a low-salt diet to help control the swelling (edema) you experience Limit foods that increase blood sugar levels when taking medications that can lead to weight gain, such as steroids

Thank you and be healthy