Understanding Nephritic Syndrome: Causes, Symptoms, Treatment & Complications

What is Nephritic Syndrome?

Nephritic syndrome is a group of glomerular diseases marked by hematuria, variable renal function loss, and hypertension.It differs from nephrotic syndrome,which involves severe proteinuria. Nephritic syndrome is a kidney disorder characterized by inflammation of the glomeruli, leading to impaired kidney function. This inflammation disrupts the filtration process, resulting in hematuria (blood in the urine), proteinuria (protein in the urine), hypertension, and reduced urine output.

Key Features of Nephritic Syndrome:

• Hematuria:A defining feature of nephritic syndrome, presenting as cola-colored or red-tinged urine due to red blood cells leaking into the urine.
• Proteinuria:While present, protein loss is typically less severe than in nephrotic syndrome, usually less than 3.0 grams per day.
• Hypertension:Increased blood pressure due to fluid retention and decreased kidney function.
• Oliguria:Reduced urine output, indicating impaired kidney filtration.
• Edema:Swelling, particularly in the face and around the eyes, due to fluid retention.

Nephritic syndrome can develop suddenly (acute nephritic syndrome) or progress over time (chronic nephritic syndrome) and may lead to serious complications, including kidney failureif untreated.

Risk Factors for Nephritic Syndrome

• Family history
• Genetics
• Age
• Smoking
• Obesity
• Autoimmune diseases like lupus, Goodpasture syndrome

Causes of Nephritic Syndrome

Acute nephritic syndrome is often triggered by an immune response following an infection or other systemic disease. The causes of nephritic syndrome vary based on age group and underlying conditions.

• Hemolytic uremic syndrome:A disorder that occurs when an infection in the digestive system produces toxic substances that destroy red blood cells and cause kidney injury
• Henoch-Schönlein purpura:A disease characterized by purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis
• IgA nephropathy:A condition where IgA antibodies build up in kidney tissue, leading to inflammation
• Post-streptococcal glomerulonephritis:A kidney disorder occurring after infection with certain strains of streptococcus bacteria

• Abdominal abscesses - Infections in the abdominal region that can lead to secondary kidney complications.
• Goodpasture syndrome - Also known as anti-glomerular basement membrane disease, where the immune system mistakenly attacks kidney and lung tissues.
• Hepatitis B or C - Viral infections that can lead to chronic kidney diseaseand glomerulonephritis.
• Endocarditis - Inflammation of the inner lining of the heart chambers and valves due to bacterial or fungal infections.
• Membranoproliferative glomerulonephritis - A disorder characterized by inflammation and structural changes in kidney cells.
• Rapidly progressive (crescentic) glomerulonephritis - A severe form of glomerulonephritis that leads to rapid kidney function loss.
• Lupus nephritis - A kidney complication of systemic lupus erythematosus (SLE), an autoimmune disease.
• Vasculitis - Inflammation of blood vessels, which can impact kidney function.
• Viral diseases - Conditions such as mononucleosis, measles, and mumps have been linked to nephritic syndrome.

Signs & Symptoms of Nephritic Syndrome

• Hematuria
• Proteinuria
• Oliguria
• Hypertension
• Fatigue
• Flank Pain
• Fever
• Edema
• Rash
• Weight Gain

• Blurred vision
• Cough containing mucus or pink
• Shortness of breath
• Headache
• Malaise
• Drowsiness
• Confusion

Diagnostic Test & Investigations

• Blood electrolytes
• Blood urea nitrogen (BUN)
• Creatinine
• Creatinine clearance
• Urinalysis
• A kidney biopsy
• ANA titer for lupus
• Antiglomerular basement membrane antibody
• Antineutrophil cytoplasmic antibody for vasculitis (ANCA)
• Blood culture
• Serum complement (C3 and C4)

Treatment for Nephritic Syndrome

Medications for Nephritic Syndrome

Corticosteroidsto reduce inflammation and suppress the immune system

Diuretics(water pills) help the kidneys eliminate excess fluid and salt, which can reduce swelling (edema) and lower blood

Angiotensin-converting enzyme (ACE) inhibitorswork by relaxing blood vessels, lowering blood pressure, and reducing protein loss in the urine

Angiotensin II Receptor Blockers (ARBs)similarly to ACE inhibitors also works by lowering blood pressure and reducing protein loss in the urine. They work by blocking the effects of angiotensin II, a hormone that causes blood vessels to constrict.

Immunosuppressantsprotects the immune system and prevent it from attacking the kidneys.

Antihypertensivessuch as diuretics or ACE inhibitors, ARBs, and nifedipine to treat high blood pressure

Antibioticssuch as penicillin are used to treat bacterial infections that may trigger nephritic syndrome, such as strep throat. Erythromycin is an alternative to penicillin-allergic patient

Statinsare cholesterol lowering drugs, which can reduce the risk of cardiovascular disease

Erythropoietinis a hormone that stimulates the production of red blood cells.

Plasma exchange,also known as plasmapheresis, is a procedure that removes harmful antibodies from the blood

In severe cases, where the condition is deteriorating leading to renal failure. Renal replacement therapy with dialysis is recommended.

Preventions of of Nephritic Syndrome

In addition to medical treatments, certain lifestyle changes can help improve nephritic syndrome and support kidney health. It is recommended for individuals to;

• Monitor blood pressure
• Limit alcohol consumption
• Quit smoking, if you smoke
• Eat a balanced diet
• Exercise regularly
• Limit salt intake to help control blood pressure and reduce fluid retention.
• Drink enough water to stay hydrated which supports kidney function and helps flush out toxins.
• Maintain a healthy weight
• Avoid processed foods high in salt and unhealthy fats as it can worsen kidney function.
• Manage stress - chronic stress can raise blood pressure