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'''Associate Editor-In-Chief:’’’ {{CZ}}
'''Associate Editor-In-Chief:’’’ {{CZ}}
==Overview==
==[[Nephritic syndrome overview|Overview]]==


:''Not to be confused with [[nephrotic syndrome]]''
==[[Nephritic syndrome historical perspective|Historical Perspective]]==
'''Nephritic syndrome''' is a collection of signs (known as a [[syndrome]]) associated with disorders affecting the [[kidney]]s, more specifically [[Glomerulus (kidney)|glomerular]] disorders. 


==Signs and symptoms==
==[[Nephritic syndrome classification|Classification]]==
Nephritic syndrome is characterized by;
*[[proteinuria]] (protein in the urine)
*[[hematuria]] (blood in the urine), with [[red blood cell]] (RBC) casts present in the urine
*[[hypertension]] (high blood pressure)
and variable [[renal failure|renal insufficiency]], with;
*[[azotemia]] (elevated blood nitrogen) 
*[[oliguria]] (low urine output <400 mL/day)
 


The main features are hypertension and RBC casts.  The proteinuria in nephritic syndrome is not usually severe, but may occasionally be heavy enough to be in the range usually found in [[nephrotic syndrome]].
==[[Nephritic syndrome pathophysiology|Pathophysiology]]==


[[Mnemonic]]: PHAROH = Proteinuria, Hematuria, Azotemia, RBC casts, Oliguria, Hypertension
==[[Nephritic syndrome causes|Causes]]==


==Diagnosis==
==[[Nephritic syndrome differential diagnosis|Differentiating Nephritic syndrome from other Diseases]]==
Nephritic syndrome is not a specific diagnosis.  It is a clinical syndrome and characterized by the above signs.


An anti-streptolysin O titre (or ASOT) is typically done to test for exposure to [[streptococci]].
==[[Nephritic syndrome epidemiology and demographics|Epidemiology and Demographics]]==


==Pathophysiology==
==[[Nephritic syndrome risk factors|Risk Factors]]==
The exact [[pathophysiology]] is dependent on the specific diagnosis. However, the common features are an [[inflammation]] of the [[glomerulus|glomeruli]], leading to salt and water retention and a reduction in the [[kidney function]].


==Differential diagnosis==
==[[Nephritic syndrome screening|Screening]]==
The two classic diagnoses of nephritic syndrome are:
*[[glomerulonephritis|post-infectious glomerulonephritis]] - also sometimes called post-streptococcal glomerulonephritis as the streptococcus is the most common cause and at one time was thought to be the only cause.
*[[glomerulonephritis|crescentic glomerulonephritis]]


Nephritic syndrome causes are usually grouped into 'focal proliferative' and 'diffuse proliferative' on the basis of [[histology]] (obtained by a renal biopsy).
==[[Nephritic syndrome natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


===Focal proliferative===
==Diagnosis==
*[[IgA nephropathy]]
[[Nephritic syndrome staging|Staging]] | [[Nephritic syndrome history and symptoms|History and Symptoms]] | [[Nephritic syndrome physical examination|Physical Examination]] | [[Nephritic syndrome laboratory findings|Laboratory Findings]] | [[Nephritic syndrome chest x ray|Chest X Ray]] | [[Nephritic syndrome CT|CT]] | [[Nephritic syndrome MRI|MRI]] | [[Nephritic syndrome other imaging findings|Other Imaging Findings]] | [[Nephritic syndrome other diagnostic studies|Other Diagnostic Studies]]
*[[chronic liver failure]]
*[[Celiac sprue]]
*[[dermatitis herpetiformis]]
*[[Henoch-Schoenlein purpura]]
*[[Alport syndrome]]
*[[lupus erythematosus|SLE]]
 
===Diffuse proliferative===
*[[focal segmental glomerulosclerosis|focal glomerulosclerosis]]
*membranoproliferative glomerulonephritis ([[malaria]], [[hepatitis B]], [[hepatitis C]], chronic infection, [[sickle-cell disease]], [[lupus erythematosus|SLE]], hemolytic uremic syndrome / [[thrombotic thrombocytopenic purpura]])
*[[cryoglobulinemia]]
*[[lupus erythematosus|SLE]]
*[[rapidly progressing glomerulonephritis]] (RPGNs) - several.


==Treatment==
==Treatment==
Treatment is dependent on the underlying etiology (cause).
[[Nephritic syndrome medical therapy|Medical Therapy]] | [[Nephritic syndrome surgery|Surgery]] | [[Nephritic syndrome primary prevention|Primary Prevention]] | [[Nephritic syndrome secondary prevention|Secondary Prevention]] | [[Nephritic syndrome cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] |  [[Nephritic syndrome future or investigational therapies|Future or Investigational Therapies]]
 
==Prognosis==
Prognosis depends on the underlying etiology.


==External links==
==Case Studies==
* [http://www.nlm.nih.gov/medlineplus/ency/article/000495.htm Acute nephritic syndrome] - medlineplus.org
* [http://www.hmc.psu.edu/healthinfo/no/nephriticsyndrome.htm Nephritic syndrome] - A to Z topics.
* [http://www.merck.com/mmhe/sec11/ch144/ch144b.html Nephritic syndrome] - Merck Manual.


==References==
[[Nephritic syndrome case study one|Case #1]]
{{reflist|2}}


{{Nephrology}}
{{Nephrology}}

Revision as of 18:38, 28 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief:’’’ Cafer Zorkun, M.D., Ph.D. [2]

Overview

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Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

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