NEPHRITIC SYNDROME:
When there is a mild to moderate protein leaking in urine, microscopic hematuria (cola coloured urine), abnormal renal function (increased serum creatinine), and swelling over body and high blood pressure is known as nephritic syndrome.
Childhood nephritic syndrome is usually self-resolving and requires no specific treatment.
In adults, kidney biopsy and specific treatment is usually required.
NEPHROTIC SYNDROME (NS)
When there is excessive protein leaking through urine which causes swelling of the body low albumin level in the blood than this is known as nephrotic syndrome.
CLINICAL FEATURES
- Swelling all over the body (early morning facial puffiness and swelling around the ankle late evening are the initial symptom )
- Frothy urine
- Breathing difficulty
- Increased body weight
INVESTIGATIONS
- Urine routine and examination
- 24 hours urine for protein and creatinine
- Serum albumin level
- Lipid profile
- Other special investigations
Like kidney biopsy, vasculitic markers like ANA, complement levels, ASO titres
TREATMENT
Conservative, BP control, steroids and immunosuppressive drugs.
CHILDHOOD NEPHROTIC SYNDROME
NS is very common during childhood. Kidney biopsy is usually is not required in childhood ns. It is easily managed by steroids. Rarely kidney biopsy and other immunosuppressive drugs are required. Childhood nephrotic syndrome can be a single episode, infrequent relapsing, frequent relapsing, and steroid dependent and steroid resistant.
Parental guidance :
Parents need to monitor the treatment response at home by decreasing swelling and daily monitoring of protein leaking by using urine albumin sticks.