ACUTE NEPHRITIC SYNDROME

Acute nephritic syndrome indicates an inflammatory process causing renal dysfunction over days to weeks that may or may not resolve.

In severe cases, it may cause more than 50% loss of nephron function over the course of just weeks or months.

It is characterized by the abrupt onset of:

• Hematuria with RBC casts or dysmorphic RBCs typically seen on urine microscopy.

• Proteinuria (usually a non-nephrotic range).

• Renal impairment: manifesting as oliguria, uremia, raised urea, and creatinine.

• Hypertension due to salt and water retention.

• Edema (usually the periorbital, leg, or sacral) due to salt and water retention.

Clinical features

• Hematuria ( micro or macroscopic)

• Proteinuria

• Hypertension

• Edema

• Oliguria

• Uremia

Glomerular diseases with nephritic presentation

Post-streptococcal glomerulonephritis (most
common)

IgA nephropathy

Henoch – schonlein purpura

Wagener’s granulomatosis

Goodpasture’s syndrome

Polyarteritis nodosa

Acute interstitial nephritis

INVESTIGATIONS

Serum chemistries

• Complement levels

• ANA, ANCA, anti- GBM antibodies,
cryoglobulins

• Hepatitis C and B

• ASO titer

• C3 nephritic factor

Urinalysis

• Dysmorphic red cells

• Red cell cast

• Proteinuria

Renal biopsy