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Difference between nephrotic syndrome and nephritic syndrome

First, know that syndrome means a set of signs and symptoms that characterize a disease or condition.

Nephritic Syndrome

The nephritic syndrome is due to acute glomerular inflammation. This inflammation of the glomeruli may occur idiopathically, as a primary kidney disease, or be secondary to some systemic disease, such as infections and collagenoses.

The classical nephritic syndrome has a sudden onset (days / weeks) and the main cause is post streptococcal glomerulonephritis. Regardless of origin, the basic condition is characterized by hematuria , mild (non-nephrotic, ie less than 3.5 g / 24h ) and oliguria(400 ml / day urine) proteinuria .

Hematuria originates from compromised glomeruli, and is the most common and most common sign of nephritic syndrome. RBCs are dysmorphic, due to migration through “ruptures” or “clefts” that arise in the capillary loops of the inflamed glomeruli.

EAS also reveals pyuria and cellular (hematic and leukocyte) cylinders .

Remember: when cylinders appear in the urine is a strong indication that there is kidney damage (glomeruli or tubules).

Nephrotic syndrome

The nephrotic syndrome can be caused by various diseases that affect the kidneys. It is characterized by massive proteinuria (greater than 3.5 g / 24 hours), with a tendency to edema , hypoalbuminemia (serum albumin less than 3.4 g / dl) and hyperlipidemia .

The massive loss of protein through urine causes hypoalbuminemia since albumin is the most abundant in the circulation. The liver fails to synthesize the proper amount of protein to balance the loss.

Hyperlipidemia is due to a greater synthesis of very low density (triglyceride carriers) and low density (cholesterol carriers) proteins. In addition, hypoalbuminemia inhibits lipolysis and stimulates the liver to produce these new proteins.

Microscopic hematuria, dysmorphic red blood cells, and hematic cylinders may rarely occur in the nephrotic syndrome.

Difference between nephrotic syndrome and nephritic syndrome

What are the differences between nephritic and nephrotic syndrome?

Nephrite syndrome occurs with the sudden appearance of hematuria and proteinuria. There are signs of azotemia, when the speed of glomerular filtration is reduced. In the body, fluid and salt are retarded, blood pressure rises. That is, all processes cause inflammation of the kidneys. Nephrotic syndrome affects the condition of the whole organism. Nephritis most often causes streptococcal infection, which manifests itself 5-6 weeks before the development of nephritic syndrome. Such stages of the disease can be: chronic, acute, subacute nature.

Chronic form of the disease occurs more often than others. It can develop against a background of reduced immunity or hereditary predisposition. In childhood, chronic nephritis develops due to the underdevelopment of the kidneys. Thus, nephritic and nephrotic syndrome have obvious differences. In a nephrotic syndrome, the kidney is affected in general, and this condition is called nephrosis. And with nephritic syndrome, inflammation reaches the glomeruli of the kidneys and is called nephritis. Differential diagnosis of nephrotic and nephritic syndrome is carried out after clinical and laboratory studies.

The nephritic syndrome is a complex of symptoms, in which significant proteinuria occurs, while the permeability of the glomerulus for proteins rises, hypoproteinemia develops, edema develops. There is a definite classification of this disease: primary view; secondary view; idiopathic appearance.

Initially, the disease of the primary form occurs against the background of the underlying ailment, which disables the work of the kidneys. In addition, there is both acquired and congenital nephrotic syndrome. Secondary form also develops in the form of kidney damage on the background of another disease. The idiopathic form has no clear cause of development. Most often this type is diagnosed in childhood.

Both nephrotic and nephritic syndromes are treated with hormones. With a nephrotic syndrome, the blood level can be reduced or increased, hence the names of the two types of disease – hypervolemic and hypovolemic syndrome. The first signs of the disease appear at 5-6 weeks after the transferred infectious disease. A person can experience the following symptoms of a syndrome: fatigue; malaise in the form of headaches; a person can vomit; pain in the lumbar region; the patient is shivering; decreased appetite. The face swells, especially in the eyelid. The amount of urine released per day decreases, but its density remains unchanged, and sometimes even increases. The urine acquires a reddish hue, this is due to the presence of blood in it. This state of affairs appears, almost from the first day of the disease, and persists for 2-3 weeks, even if the disease is chronic. There is hematuria, proteinuria, the cylinders in erythrocytes increase. The accumulation of fluid in the body can appear unnoticed, so it is very important to carry out a McClure test in time for timely diagnosis of the nephrotic syndrome. Violated the work of the heart and blood vessels. Hypertension is often observed, the borders of the heart are enlarged. Noises are heard in the heart, the heart rhythm is broken. On the ECG will be revealed deviations. As the small circle of the cardiac circulation changes, the person has shortness of breath.

The liver is increased to 6 cm. If you start treatment and do not start the process of kidney disorders, then gradually all the symptoms will disappear. In 2-3 months the kidneys can completely restore their work. If the treatment was done incorrectly or not at all, it is possible that kidney eclampsia develops. This causes cerebral edema and increased cranial pressure. With the chronic form of the disease, such a process will be somewhat remote, but it is extremely necessary to identify violations in time and begin therapy.


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