From the Guidelines
Nephritic syndrome and nephrotic syndrome are two distinct kidney disorders with different clinical presentations and underlying mechanisms, with nephritic syndrome characterized by inflammation and hematuria, and nephrotic syndrome defined by massive proteinuria and hypoalbuminemia. The key difference between the two syndromes lies in their pathophysiology, with nephritic syndrome involving inflammatory damage to the glomerular basement membrane and nephrotic syndrome involving damage to the podocytes, leading to massive protein loss through urine 1.
Clinical Presentation
Nephritic syndrome typically presents with:
- Hematuria (blood in urine)
- Mild proteinuria (protein in urine)
- Hypertension
- Decreased kidney function
- Cola-colored or smoky urine
- Edema
- Elevated blood pressure Common causes of nephritic syndrome include post-streptococcal glomerulonephritis, IgA nephropathy, and lupus nephritis.
Nephrotic Syndrome
In contrast, nephrotic syndrome is defined by:
- Massive proteinuria (>3.5g/day)
- Hypoalbuminemia (low blood albumin)
- Hyperlipidemia (high cholesterol)
- Significant edema Patients with nephrotic syndrome typically present with severe swelling, particularly around the eyes, ankles, and abdomen, but usually have normal blood pressure and kidney function initially. Common causes of nephrotic syndrome include minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and diabetic nephropathy.
Comparison Table
| Characteristic | Nephritic Syndrome | Nephrotic Syndrome |
|---|---|---|
| Proteinuria | Mild (<3.5g/day) | Massive (>3.5g/day) |
| Hematuria | Present | Absent |
| Hypertension | Present | Absent (initially) |
| Kidney Function | Decreased | Normal (initially) |
| Edema | Present | Present |
| Blood Pressure | Elevated | Normal (initially) |
Mnemonic
To remember the key differences between nephritic and nephrotic syndrome, use the following mnemonic: "Nephritic: Hematuria, Hypertension, Decreased kidney function" "Nephrotic: Massive proteinuria, Hypoalbuminemia, Hyperlipidemia"
In summary, nephritic syndrome and nephrotic syndrome are two distinct kidney disorders with different clinical presentations and underlying mechanisms, and accurate diagnosis and treatment are crucial to improve patient outcomes 1.
From the Research
Difference between Nephritic and Nephrotic Syndrome
The main differences between nephritic and nephrotic syndrome are:
- Clinical Presentation: Nephrotic syndrome is characterized by heavy proteinuria, hypoalbuminemia, and peripheral edema, whereas nephritic syndrome is associated with hematuria, proteinuria, and abnormal kidney function 2.
- Proteinuria: Nephrotic syndrome is defined by proteinuria greater than 3.5 g/24 hours, whereas nephritic syndrome has variable levels of proteinuria 3, 4.
- Kidney Function: Nephritic syndrome is typically associated with hypertension and abnormal kidney function, whereas nephrotic syndrome may have normal or mildly impaired kidney function 2.
- Complications: Nephrotic syndrome is associated with hyperlipidemia, thrombotic disease, and infection, whereas nephritic syndrome carries a poorer prognosis and is associated with hypertension and gradual loss of kidney function 3, 2.
Table Comparing Nephritic and Nephrotic Syndrome
| Characteristic | Nephrotic Syndrome | Nephritic Syndrome |
|---|---|---|
| Proteinuria | > 3.5 g/24 hours | Variable |
| Hypoalbuminemia | Present | Absent |
| Edema | Present | Absent |
| Hematuria | Absent | Present |
| Kidney Function | Normal or mildly impaired | Abnormal |
| Complications | Hyperlipidemia, thrombotic disease, infection | Hypertension, gradual loss of kidney function |
Mnemonic to Remember the Difference
Use the mnemonic "NEPHROTIC" to remember the characteristics of nephrotic syndrome:
- N: Normal kidney function
- E: Edema
- P: Proteinuria > 3.5 g/24 hours
- H: Hypoalbuminemia
- R: Renal biopsy often necessary
- O: Often associated with hyperlipidemia and thrombotic disease
- T: Treatment includes immunosuppressive agents and ACE inhibitors
- I: Infection and thromboembolism are potential complications
- C: Characterized by heavy proteinuria and hypoalbuminemia
Use the mnemonic "NEPHRITIC" to remember the characteristics of nephritic syndrome:
- N: Normal or impaired kidney function
- E: Edema absent
- P: Proteinuria variable
- H: Hematuria present
- R: Renal biopsy often necessary
- I: Infection and hypertension are potential complications
- T: Treatment includes immunosuppressive agents and ACE inhibitors
- I: Impaired kidney function
- C: Characterized by hematuria and proteinuria