Terminology

• Nephritis is a very generic term that means inflammation of the kidneys
• Nephritic and nephritic syndrome refer to groups of symptoms without specifying the underlying cause
• Glomerulonephritis (GN) is an umbrella term applied to conditions that cause inflammation of or around the glomerulus and nephron
• All forms of GN can cause a nephritic or nephrotic symdrome but different forms have a tendency to cause one or the other or mixed
• Secondary glomerular disease can also cause nephrotic syndrome e.g. amyloidosis or diabetic nephropathy, or mixed nephrotic/nephritic syndrome e.g. SLE, HSP

Nephritic syndrome

• Indicative of a proliferative process affecting endothelial and mesangial cells

Clinical features

• Haematuria/active urinary sediment (RBC and granular casts, proteinuria)
• Oliguria
• Oedema/fluid retention
• Hypertension
• Acute renal failure

Nephrotic syndrome

• Indicative of a non-proliferative process affecting podocytes

Clinical features

• Heavy proteinuria (> 3 g/day)
• Hypoalbuminaemia
• Non-dependent oedema, classically periorbital