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Obstetrics and Gynaecology
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Nephritic Syndrome


Nephritic syndrome is a clinical condition characterized by a group of symptoms that occur as a result of inflammation and damage to the glomeruli, the filtering units of the kidneys. It is typically caused by various types of glomerulonephritis, which are conditions involving inflammation of the glomeruli.

The key features of the nephritic syndrome include:

    1. Hematuria: The presence of blood in the urine, which may cause the urine to appear pink, red, or brown.

    1. Proteinuria: The presence of excess protein in the urine, which may result in foamy urine.

    1. Hypertension: High blood pressure is commonly associated with nephritic syndrome.

    1. Edema: Swelling, usually around the eyes, face, hands, feet, and ankles, due to fluid retention.

    1. Decreased urine output: The kidneys may produce less urine than normal.

    1. Azotemia: Elevated levels of nitrogenous waste products (such as blood urea nitrogen and creatinine) in the blood due to decreased kidney function.

    1. Oliguria: Reduced urine output, often defined as urine volume less than 400 milliliters per day.

The nephritic syndrome can have several underlying causes, including:

    1. Post-streptococcal glomerulonephritis: A common cause, occurring after an infection with certain strains of streptococcal bacteria, such as those that cause strep throat or skin infections.

    1. IgA nephropathy: Also known as Berger’s disease, this condition involves the deposition of immunoglobulin A (IgA) antibodies in the glomeruli.

    1. Membranoproliferative glomerulonephritis (MPGN): A chronic inflammatory condition characterized by thickening of the glomerular basement membrane.

    1. Lupus nephritis: Kidney involvement in systemic lupus erythematosus (SLE), an autoimmune disease.

    1. Another glomerulonephritis: There are various other forms of glomerulonephritis that can lead to a nephritic syndrome, such as rapidly progressive glomerulonephritis (RPGN) or anti-glomerular basement membrane (anti-GBM) disease.

Diagnosis of nephritic syndrome involves a combination of clinical evaluation, medical history review, physical examination, and diagnostic tests, including urine analysis, blood tests, kidney biopsy, and imaging studies. These investigations help determine the underlying cause and severity of the condition.

Treatment for nephritic syndrome aims to manage symptoms, control blood pressure, and treat the underlying cause. Treatment options may include:

    1. Medications: Depending on the specific cause, medications such as corticosteroids, immunosuppressive drugs, antihypertensives, and diuretics may be prescribed.

    1. Dietary modifications: Reducing salt intake and maintaining a balanced diet may be recommended to manage edema and control blood pressure.

    1. Supportive care: Adequate rest, hydration, and close monitoring of kidney function are important components of management.

Nephrotic Syndrome


Nephrotic syndrome is a kidney disorder characterized by significant proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

The key features of nephrotic syndrome include:

    1. Proteinuria: The hallmark of nephrotic syndrome is the presence of excessive protein in the urine more than 3g/day. This leads to foamy or frothy urine.

    1. Hypoalbuminemia: Reduced levels of albumin, a major protein in the blood, occur due to its loss in the urine. Low albumin levels can contribute to fluid accumulation and edema.

    1. Edema: Fluid retention in the body causes swelling, typically in the face, legs, ankles, and hands. Edema is a common symptom of nephrotic syndrome.

    1. Hyperlipidemia: Abnormal elevations in blood lipid levels, including cholesterol and triglycerides, often accompany nephrotic syndrome.

Diagnosis:  tests may include urine analysis, blood tests (including serum albumin and lipid levels), kidney biopsy, and imaging studies to determine the underlying cause and evaluate kidney function.

Treatment:

    1. Medications: Corticosteroids, such as prednisone, are commonly used to reduce inflammation and proteinuria. 

    1. Diuretics: Medications that help eliminate excess fluid from the body and reduce edema.

Key Points To Remember


    • Nephritic: Blood in Urin

    • Nephrotic: Protein in Urin more than 3 gm

    • Interstitial Nephritis: Fever than Disease



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