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Summary Essential Notes: Renal Medicine: Nephrotic vs. Nephritic
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Nephrotic vs. Nephritic syndromeNephrotic syndrome Ix
Definition Bloods: FBC, WCC, platelets, U&Es,
Classic triad of: LFTs, creatinine, urea, CRP, ESR,
1. Proteinuria >3g/24h glucose, lipid profile
2. Hypoalbuminaemia (<30g/dL) and Urinalysis: blood, protein, glucoses,
3. Oedema leucocytes, nitrates + Bence-Jones
Loss of anti-thrombin III, protein C + S + proteins
association rise in fibrinogen levels Nephritic screen: serum complement
increased risk of thrombosis (C3+C4), ANA, dsDNA, ANCA, anti-
Loss of thyroxine-binding globulin lowers GBM, HBV/HCV serology, cultures,
total, but not free thyroxine levels VDRL for syphilis
Renal biopsy
Signs + symptoms Radiology: USS
Proteinuria
Hypoalbuminaemia Mx
Hyperlipidaemia hypoproteinaemia Conservative: lifestyle advice, reduce
production of more proteins from salt intake <6g/day
liver, which results in synthesis of Medical: Rx depends on cause
more lipoproteins, low levels of Rx HTN, proteinuria,
lipoprotein lipase reduced lipid hypercholesterolaemia
catabolism Immunotherapy regimen e.g.
Oedema prednisolone, cyclophosphamide +
azathioprine
Aetiology
Minimal change disease child w/ Complications
nephrotic syndrome (80%) High risk of infection = urinary Ig loss
Focal segmental glomerulosclerosis High VTE risk = loss of ATIII,
idiopathic/secondary to HIV plasminogen
Membranous glomerulonephritis Hyperlipidaemia (Vit D + binding
proteinuria, nephrotic + CKD protein lost)
Diabetic nephropathy Hypocalcaemia
Amyloidosis AKI
Mesangial proliferative glomerulonephritis
SLE
Nephritic syndrome
Aetiology
Focal proliferative
IgA nephropathy (typically young people
w/ haematuria following URTI)
SLE
Nephritic syndrome Henoch-Schonlein Purpura
Alport syndrome
Signs + symptoms ‘PHARAOH’
Diffuse proliferative
Proteinuria Rapidly progressive glomerulonephritis
Haematuria e.g. Good pasture’s, Wegner’s
Azotaemia (High N-containing compounds SLE
e.g. urea, creatinine) Membranoproliferative GN
Red blood cell casts Cryoglobulinaemia
Anti-streptolysin O titres Ix (Same as nephrotic syndrome)
Oliguria Mx (Same as nephrotic syndrome)
Hypertension
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