Edema may also be present, although it is not nearly as severe as in nephrotic syndrome. The nephrotic syndrome is defined by a urinary protein level exceeding 3. Childhood nephrotic syndrome is a group of symptoms that occur because of damage to the kidneys. Assessment of nephrotic syndrome differential diagnosis. Rapidly progressive renal failure is a hall mark of rapidly progressive glomerulonephritis syndrome and presents with nephritic urine picture8. A healthy diet for nephrotic syndrome patients consists of low salt, low fat and low cholesterol, with emphasis on fruits and vegetables. The most common primary glomerular diseases include membranous nephropathy, focal segmental glomerular sclerosis, minimal change, and membranoproliferative glomerulonephritis mpgn. Acute post infectious glomerulonephritis apign describes a.
The cause remains unknown but the pathogenesis of idiopathic ns is thought to involve immune dysregulation, systemic circulating factors, or inherited structural abnormalities of the podocyte. Studies suggest that the pathogenesis of edema in individual patients may occur via widely variable. Hematuria originates from compromised glomeruli, and is the most. At the turn of the century, clinicians distinguished a nephritic syndrome of i. The classical nephritic syndrome has a sudden onset days weeks and the main cause is post streptococcal glomerulonephritis. Diagnosis and management charles kodner, md, university of louisville school of medicine, louisville, kentucky i n nephrotic syndrome, a. In the nephrotic syndrome, there is effacement of the foot process, but the rest of the cell usually is preserved. Nephrotic syndrome is kidney disease with proteinuria. Nephrotic syndrome is defined as the presence of proteinuria 3. Difference between nephrotic syndrome and nephritic. In children, nephrotic syndrome causes these symptoms.
Basic information nephrotic syndrome ns reflects glomerular dysfunction causing proteinuria without compromising gfr occurs at all ages but is most prevalent in children between the ages 1. The nephrotic syndrome american academy of pediatrics. Nephrotic and nephritic syndrome in the newborn clinics in. Pdf acute glomerulonephritis mimicking nephrotic syndrome. Relapses are treated with a 2nd course of steroids. Overview of nephritic syndrome genitourinary disorders. Nephrotic syndrome see figure 1 is usually a chronic condition and with the exception of mcd, most causes eventually lead to chronic progressive renal failure. Endothelial cells have numerous openings that are 70 to 100 nm in diameter, called fenestrae, which form a physical barrier for passage of. Nephrotic syndrome ns consists of peripheral edema, heavy proteinuria, and hypoalbuminemia, often with hyper lipidemia. The finnish type is an autosomal recessive disorder most common presents during the. Roger seheult, md of illustrates the key differences between the nephrotic and nephritic syndromes.
Common causes of nephrotic syndrome are listed in table 3. Patrick niaudet, in comprehensive pediatric nephrology, 2008. This condition is caused by other diseases, such as diabetes or lupus. The predominant cause of the nephrotic syndrome in children is minimal change disease. Most minimal change diseases do respond to corticosteroids and a small fraction of patients are steroid dependent. Nephritic syndrome is a clinical syndrome defined by the association of hematuria, proteinuria, and often arterial hypertension and renal failure. Nephrotic syndrome can affect children of any age, from infancy to adolescence, and is most commonly seen among schoolaged children and adolescents. Common causes of nephritic syndrome are listed in table 4. 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. Nephrotic syndrome overview sign and symptoms, pathophysiology. Below is just a quick overview of which diseases are associated with which.
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. Nephritic syndrome is characterized by glomerular damage leading to hematuria. Nephrotic syndrome may affect adults and children of both sexes and of any race. This is because each is associated with a particular subset of diseases. The prevalence worldwide is approximately 16 cases per 100,000 children with an incidence of 2 to 7 per 100,000 children. First deciding between nephritic and nephrotic syndrome is a useful starting point for your differential diagnosis. Identification of patients with minimal change nephrotic syndrome from initial response to prednisone. 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.
Nephrotic syndrome is a kidney disorder where the body releases too much protein into the urine. In the united states, diabetes mellitus is the most common cause of nephrotic syndrome. Nephritic syndrome can present with oliguria, hypertension, and hematuria colacolored urine. It can be caused by a variety of conditions including autoimmune, hereditary, and infectious diseases. Regardless of origin, the basic condition is characterized by hematuria, mild nonnephrotic, ie less than 3. Nephrotic syndrome is a condition involving the loss of significant volumes of protein via the kidneys proteinuria which results in. A report of the international study of kidney disease in children. Roger seheult, md of, illustrates the key differences between the nephritic and nephrotic syndromes. Just like nephritic syndrome, this one also has following features.
Nephritic syndrome oxford medicine oxford medicine online. Patients typically present with edema and fatigue, without evidence of. Diagnosis and management charles kodner, md, university of louisville school of medicine, louisville, kentucky i n nephrotic syndrome, a variety of disorders cause. Laboratory findings include hematuria, proteinuria ment of nephrotic syndrome in. Nephrotic vs nephritic syndrome proteinuria, hematuria, casts. Nephrotic syndrome is a collection of symptoms that indicate kidney damage. The underlying abnormality in nephrotic syndrome is an permeability of the glomerular capillary wall proteinuria and hypoalbuminemia. Nephrotic syndrome investigations quantify how severe nephrotic syndrome. 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. Pediatric nephrotic syndrome adam goldstein howard trachtman, m. Nephrotic syndrome can occur in children at any age, but usually is found in children between 18 months and 5 years of age. The most common causes of nephritic syndrome are post infectious. Nephrotic syndrome vs nephritic syndrome explained nephritic vs. This learning card provides an overview of nephritic syndrome.
Nephritic syndrome knowledge for medical students and. Consequently, this group and the japanese society of nephrology jsn published the second guideline, guideline for nephrotic syndrome, in 2011. Nephritic syndrome knowledge for medical students and physicians. Nephrotic syndrome vs nephritic syndrome explained nephritic vs nephrotic. Nephritic syndrome is characterized by glomerular damage leading to hematuria, pyuria, water retention, and subsequent hypertension and edema. Congenital nephrotic syndrome cns presents within the first 3 months of life with massive proteinuria, hypoalbuminemia, and edema. Pediatric nephrotic syndrome national kidney foundation. Nephrotic syndrome is a group of symptoms that, together, show that your kidneys are not working as well as they should. While the nephrotic syndrome is mediated by damage to the podocyte an epithelial cell and the glomerular basement membrane gbm, nephritic syndrome. Nephritic syndrome an overview sciencedirect topics. Clinicopathological study of nephrotic syndrome in childhood. Nephrotic syndrome can be inherited from a number of genetic mutations that lead to defects in various regions of the glomerular.
Nephritic syndrome is a clinical syndrome defined by. Most children up to 80% will go on to relapse several times proteinuria 3d with edema. The amount of protein and fluid a patient with nephrotic syndrome should have depends on. However, some glomerular diseases especially the mpgn can present as nephrotic or nephritic. Although primary ns is a relatively rare condition, anyone can get it. Evidencebased clinical practice guidelines for nephrotic. Nephrotic or nephritic syndrome can be caused by multiple disease processes. Nephrotic syndrome is an important clinical condition affecting both children and adults. The incidence of idiopathic nephrotic syndrome ns is 115169 per 100 000 children, varying by ethnicity and region. Low levels of protein in your blood hypoalbuminia swelling in your legs, feet, ankles, or hands edema sign up to download a protein guide and receive free lowprotein recipes. It may occur in typical form, or in association with nephritic syndrome. Laboratory findings include hematuria, proteinuria nephritic syndrome is characterized by glomerular damage leading to hematuria, pyuria, water retention, and subsequent hypertension and edema.