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Nephritic Syndrome Nephrotic Syndrome

Definition

- Hematuria

- Azotemia - BUN (blood urea nitrogen)

- Proteinuria

- Oliguria

- Edema

- Hypertension

Definition

- Massive proteinuria (>3.5 g/day)

- H ypoalbuminaemia plasma albumin

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Acute proliferative GN (any cause) can progress to Rapidly progressive GN (crescentic GN) Minimal change GN (Children 65%) Membranous GN (Adult 40%)

Crescentic GN (Rapidly progressive GN)

Epithelial cell proliferate

Urinary space constricted

- < 6 years old

- Males predominant

- Proteinuria selective

- protein MW albumin

- URTI preceeds

- History of

- allergies

- recent immunisation

- Complete remission (cure) common after

steroid course

Right Normal

Left Abnormal Fusion of foot processes

Membranous GN

- Adults

- Characteristic by immune deposits (e- dense)

along subepithelium (epithelial side of GBM)

Pathogenesis

- C hronic antigen-antibody

- Genetic

- HLR DR/2 (Japanese)

- HLR DR/3 (European)

- Imbalance of T -helper / T-suppressor cells

- Circulating immune complexes (15 -25%)

- Intrinsic tissue antigen present (in visceral

epithelial cells)

Causes

- Primary

- Secondary diabetes, SLE, Amyloidosis,infection (malaria, HBV), malignancy

Right Normal

Left Abnormal Thickened glomerular

capillary walls

Thickened capillary loop

No cellular proliferation