MedComic

Nephritic vs. Nephrotic Syndrome

Jorge Muniz ·
Educational medical illustration comparing nephritic syndrome (glomerulonephritis with hematuria, oliguria, hypertension, and red cell casts) and nephrotic syndrome (massive proteinuria greater than 3.5 g/day, hypoalbuminemia, hyperlipidemia, and generalized edema), including causes such as IgA nephropathy, minimal change disease, and focal segmental glomerulosclerosis
Illustrated guide comparing nephritic syndrome and nephrotic syndrome — including pathophysiology, clinical presentation, laboratory findings, and common causes in adults and children. Proprietary medical illustration by Jorge Muniz, PA-C.

Nephritic Syndrome

Nephritic syndrome is characterized by inflammation of the glomeruli (glomerulonephritis) and renal dysfunction. The most common cause is immunoglobulin A (IgA) nephropathy, also known as Berger's disease. Other causes include postinfectious glomerulonephritis and lupus nephritis.

Clinical Presentation

  • Oliguria
  • Hypertension
  • Hematuria (cola-colored urine)
  • Edema may be present but is less severe than in nephrotic syndrome

Laboratory Findings

  • Hematuria
  • Proteinuria (< 3.0 g/day)
  • Elevated BUN and creatinine
  • Red cell casts in urine

Nephrotic Syndrome

Nephrotic syndrome develops as damage to glomeruli results in massive proteinuria and generalized edema (anasarca).

Common Causes

  • Adults: Diabetes mellitus, amyloidosis, systemic lupus erythematosus (SLE), and focal segmental glomerulosclerosis
  • Children: Minimal change disease (most common)

Pathophysiology

The edema decreases intravascular fluid and blood pressure, triggering renin release by the kidneys. Aldosterone subsequently increases to retain sodium and water, worsening edema.

Laboratory Findings

  • Hypoalbuminemia
  • Massive proteinuria (> 3.5 g/day)
  • Hyperlipidemia
  • Waxy casts and oval fat bodies in urine

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