Nephritic syndrome

Presentation- Oliguria, hematuria,  HTN, AKI

*PSGN, lupus, croglobulinemia, HSP C3↓, Ig A C3 normal

1.Post-streptoccal glomerulonephritis (PSGN)

Prevalence- 2~6 y/o

Etiology- 14 days after Group A streptococcus infection


1.Normal C4, C3↓ & C50↓(first 2 wks), 1~2 months recover

2.ASO, anti-DNase B, anti-NAD, and AHase elevated→ after pharyngeal infection(1~3 wks)

3.Anti-DNase B and AHase elevated→ after skin infection(3~6 wks)

Pathology- Dome-shaped subepithelial→ humps

Prognosis- Diuresis 1 wks, Cre recover 3~4 wks, hematuria recover 3~6 wks, proteinuria recover slower


1.Membranoproliferative glomerulonephritis (MPGN)→ urinary abnormalities and hypocomplementemia beyond 4 to 6 weeks

2.Ig A nephropathy→ shorter time between the antecedent illness and hematuria


1.Supprotive care- sodium and water restriction and loop diuretics

2.Still infection- Penicillin

3.Blood pressure control- nicardipine

4.Acute renal failure- dialysis

2.Ig A nephropathy

Forward- Nephritic most common

Prevalence- 10~30 y/o male

Etiology- 2 days after URI, Liver cirrhosis, Crohn’s, GI tumor, COPD, ankylosing spondylitis

Lab- IgA↑ , C3 normal

Treatment- Corticosteroid + ACEi

Prognosis- ⅓ became CRF after 20 years

3.Alport syndrome

Gene- X-linked, XD

Etiology- Type 4 collagen defect

Presentation- Deaf, cataract,anterior lenticonus

Prognosis- Male ESRD, female only subclinical hearing loss and intermittent hematuria

4.Anaphylactoid purpura (Henoch-Schonlein purpura)(HSP)

Forward- After URI

Prevalence- 4~7 y/o

Presentation- Lower limbs palpable purpura, abdominal pain, joint pain, microscopic hematuria



2.Palpable purpura

3.Bowel angina

4.Biopsy showed granulocyte on vessel wall

Pathology- Leukocytoclastic vasculitis(Ig A and C3), kidney(Ig A in mesangium)(Berger disease)

Treatment- Good prognosis without treatment

5.Lupus nephritis (SLE)

Published by Steve Johnson

I am a doctor who like to organise knowledges and share ideas with others. As a doctor, a lot of knowledges influx everyday and need some patient to organise and absorb. Here was my notes to share with you and hope to save your time to know it.

Leave a comment

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: