Nephrotic versus nephritic syndrome
Both glomerular disorders cause impaired filtration in the kidneys.
The nephrotic syndrome is a condition of large-scale proteinuria (1p405). Its cause is damaged glomeruli that are unable to retain protein resulting in hypoalbuminea that creates a fall in blood osmotic pressure and systemic edema (1p405). Hyperlipidemia also occurs because of increased liver synthesis of lipoprotein to respond to low plasma protein (1p405). In addition to treatment for the underlying reason for the syndrome (which can include antibiotics, diuretics or statins), treatment is necessary to reduce protein in the urine and can include ACE inhibitors or ARBs (2).
The nephritc syndrome is a result of inflammatory damage restricting filtration allowing red blood cells to escape to urine causing hematuria (1p406). There is less urine output, or oliguria, which causes nitrogenous wastes to accumulate causing azotemia (1p406). Systemic hypertension also results since the increased blood pressure is used as a way to compensate for lower filtration and retained fluid (1p406). Some protein loss can occur, but not nearly as much as in nephrotic syndrome (1p406). Treatment for underlying causes for infection or HIV/HCV is necessary, but in some acute or severe cases complete renal failure is the end (1p407)
1. Nowak TJ, Handford AG. Pathophysiology: Concepts and Applications for Health Professionals. New York: McGraw-Hill, 2004.
2. Mayo Clinic. Nephrotic syndrome: Treaments. Available at: http://www.mayoclinic.com/health/nephrotic-syndrome/DS01047/DSECTION=treatments-and-drugs.