Merck Manual

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Overview of Nephritic Syndrome

By

Frank O'Brien

, MD, Washington University in St. Louis

Reviewed/Revised Jun 2023
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Topic Resources

Nephritic syndrome is defined by hematuria, variable degrees of proteinuria, usually dysmorphic red blood cells (RBCs), and often RBC casts on microscopic examination of urinary sediment. Often 1 of the following elements are present: edema, hypertension, elevated serum creatinine, and oliguria. Nephritic syndrome has both primary and secondary causes. Diagnosis is based on history, physical examination, and sometimes renal biopsy Renal biopsy Biopsy of the urinary tract requires a trained specialist (nephrologist, urologist, or interventional radiologist). Indications for diagnostic biopsy include unexplained nephritic or nephrotic... read more . Treatment and prognosis vary by cause.

Nephritic syndrome is a manifestation of glomerular inflammation (glomerulonephritis) and occurs at any age. Causes differ by age (see table ), and mechanisms differ by cause. The syndrome can be

  • Acute (serum creatinine rises over many weeks or less)

  • Chronic (renal insufficiency may progress over years)

Nephritic syndrome can also be

  • Primary (idiopathic)

  • Secondary

Table

Acute glomerulonephritis

Postinfectious glomerulonephritis Postinfectious Glomerulonephritis (PIGN) Postinfectious glomerulonephritis occurs after infection, usually with a nephritogenic strain of group A beta-hemolytic streptococcus. Diagnosis is suggested by history and urinalysis and confirmed... read more Postinfectious Glomerulonephritis (PIGN) is the prototype of acute glomerulonephritis, but the condition may be caused by other glomerulopathies and by systemic disorders such as systemic rheumatic diseases and hematologic dyscrasias (see table ).

Chronic glomerulonephritis

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