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What causes nephritic syndrome?

Inflammatory changes in the kidneys that interfere with its working, constitute nephritic syndrome. According to experts like Best Nephrologist in Lahore, nephritic syndrome may occur secondary to many causes, in people of all age groups. With proper diagnosis and treatment, the inflammatory changes in the renal tissue are reversible. If complications occur, however, the patient may go on to develop renal failure. Read on to know more about nephritic syndrome:

What is nephritic syndrome?

As mentioned before, nephritic syndrome occurs predominantly due to inflammation of the glomeruli—which are the blood vessels in the filtering subunit of the kidney. With inflammation, the pores in the blood vessels enlarge enough to pass red blood cells and proteins in the urine. Consequently, there is hematuria and proteinuria, along with other symptoms like hypertension and edema.

The major pathology in nephritic syndrome is the inflammation of the glomeruli due to any cause—like infection, hereditary diseases and autoimmune disorders like systemic lupus erythematosus (SLE). The sudden or the acute form is rapidly-progressive, while the chronic form typically has slower onset and may go undetected for a period of time.

Like nephrotic syndrome, nephritic syndrome is not a disease in itself, but a constellation of symptoms occurring together secondary to other conditions. Nephritic syndrome can have many triggers and part of the treatment involves identification of these underlying factors.

What are the causes of nephritic syndrome?

Nephritic syndrome can occur due to:

  • Bacterial infections: nephritic syndrome is common following infections like methicillin-resistant staphylococcus aureus (MRSA), typhoid, secondary syphilis and pneumococcal pneumonia. In children, nephritic syndrome is common in children following streptococcal throat infection.
  • Primary glomerular disease: one of the commonest reasons for nephritic syndrome is IgA nephropathy (Berger’s disease).
  • Parasitic infections: such as malaria is associated with nephritic syndrome.
  • Multisystem inflammatory disease: systemic disorders like vasculitis, granulomatosis with polyangiitis, Goodpasture’s, lupus or Henoch-Schoenlein purpura.  
  • Abdominal abscess: pocket of infection in the body particularly the abdomen, can predispose to nephritic syndrome.
  • Viral infections: common infections linked to nephritic syndrome include hepatitis, mumps, chickenpox, measles and infectious mononucleosis.

How is nephritic syndrome diagnosed?

The symptoms of acute nephritic syndrome include:

  • Hematuria: with nephritic syndrome there is blood in the urine. This can be microscopic or macroscopic.  
  • Edema: due to loss of protein in the urine, there is edema in the body. The sites where edema is most prominent includes the eyes, feet, abdomen, legs and face.
  • Oliguria: low urine output is also called oliguria. By definition, this is production of less than 500ml of urine over a period of 24-hours.
  • High blood pressure: disruption of kidney function can lead to raise in blood pressure, typically above 140 mmHg systolic and 90 mmHg diastolic. This hypertension is mostly refractory to medication.
  • Blurred vision: when the retinal blood vessels are involved, there is blurred vision as well.
  • Fever: there is fever in nephritic syndrome
  • Weakness: malaise and weakness are common in nephritic syndrome.
  • Fatigue: patient also complains of fatigue.
  • Loss of appetite: the appetite is greatly reduced.
  • Abdominal pain: kidney pain can manifest as abdominal pain
  • Kidney failure: may occur in later stages of disease without treatment.

The symptoms of chronic nephritic syndrome include:

  • Nausea and vomiting
  • Itchy skin
  • Decreased appetite
  • Difficulty breathing

Nephrotic syndrome vs nephritic syndrome

While they may sound similar, both nephritic syndrome and nephrotic syndrome are different kidney disorders. Nephrotic syndrome involves severe proteinuria, and high urinary albumin. Nephritic syndrome, on the other hand, has glomerular inflammation as the major feature. Of both these kidney disorders, Nephrotic syndrome is more serious and urgent. The diagnosis of nephritic versus nephrotic needs a thorough clinical examination and investigation by the healthcare provider.

What are the treatment options?

Nephritic syndrome involves tailored therapy, depending on the causative factor. General treatment involves: bed rest, anti-inflammatory medication, diet restricted in salt and fluid, medication to manage hypertension, diuretics and dialysis to replace kidney function if the disease progresses to kidney failure. More information about nephritic syndrome is available on oladoc.com.