Nephritic Syndrome With Pathology

Weekly Health and Fitness Corner

"...nephritic syndrome is a collection of signs and symptoms that result from glomerulonephritis which is inflammation of the kidney specifically the glomerulus this could be remembered because it means inflammation rather than being a disease itself nephritic syndrome is the manifestation of an underlying disease that causes the inflammation and there are many of these causes it is easily confused with nephrotic syndrome which instead is a collection of signs and symptoms resulting from a high amount of protein being lost through the kidneys in the urine this leads to hypoalbuminemia meaning low levels of albumin in the blood these are the two defining features in nephrotic syndrome there is some overlap but nephritic syndrome is different in that the degree of proteinuria is lower and there is the dozens of hematuria meaning blood in the urine which could be microscopic or macroscopic red blood cell casts in the urine sterile / urea which is the presence of white blood cells without evidence of bacteria hypertension and oliguria which is a reduced urine output typically between 80 and 400 ml per day the functional unit of the kidney is the Nephron which includes the glomerulus and modified capillary surrounding this there are multiple layers which together form a filter these include a fenestrated endothelium the glomerular basement membrane and the foot processes of podocytes which are cells that wrap around the capillary in most cases of nephritic syndrome there is a trigger causing inflammation in this area overall featuring cellular proliferation complement activation recruitment of leukocytes and production of proteases and free radicals that ultimately lead to injury of the kidney this then leads to the characteristic features for example injury to the glomerular filtration membrane allows protein to leak into the urine though not as much as is seen in nephrotic syndrome red blood cells can also pass through causing hematuria and they can be dysmorphic with a camping sites in particular suggesting glomerular injury red blood cells can also Clump together within the tubules forming cylindrical structures called castes in fact this is considered suggestive of glomerulonephritis the injury and inflammation means white blood cells are recruited and can pass into the urine and as we said it's termed sterile pyuria because there..."

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