Nephritic Syndrome and Its Pathological Diagnosis

Nephritic syndrome is featured by massive quantity of protein urine (24 hour protein leakage is more than 3.5g), serum albumin is less than 30g/L, hyperlipemia and edema. and the former two symptoms are the most typical.

Nephritic syndrome is also classified as primary or secondary kidney disease. Secondary nephritic syndrome can be caused by immunological diseases like Immunotherapyic lupus Erythematosus, diabetes, secondary infections of bacteria, hepatitis B virus and so on, circulation Immunotherapy disease and drug poisoning.
Syndrome means that in various pathological processes, the occurrence of one certain symptom will lead to or be accompanied by other several symptoms. This group of symptoms is case-hardened, so they are generally observed and analyzed as a whole. Various symptoms of syndrome can be the result of one basic factor.
The basic factor of nephritic syndrome is the massive leakage of protein. Damages to glomerular filtration membrane enhance its permeability, which lead to the massive leakage of protein. And other symptoms include proteinemia(Proteinuria and Kidney Disease), hyperlipemia and edema(Swelling and Kidney Disease).
Massive leakage of protein (fro patients with nephritic syndrome, daily protein leakage is more than 3.5g) reduces the protein concentration in the blood. Protein is the most important substance in blood to maintain plasma collide osmotic pressure. When blood protein, especially albumin, level decreases, plasma collide osmotic pressure will decline, which leads to fluid filtration from vessel to inter-organizational membranes, which give rise to edema and blood volume decrease. Blood volume decrease leads to blood and oxygen insufficiency of renal tissue, which gives rise to more secretion of renin that works for contracting vessels. Massive protein leakage enhance the albumin synthesize ability of liver. As liver synthesize more lipoprotein at the same time, lipid concentration in the blood will increase and finally give rise to hyperlipemia.
As I have mentioned in the article For Patient with Kidney Disease, Why Taking Biopsy is so important, for patients with Nephritic Syndrome the making clear of pathological diagnosis is very important for the adoption of corresponding treatment methods.
The followings are several types of nephritic syndrome .
Kidney disease with slight renal pathological changes accounts for 80% nephritic syndrome in children and 25% in adults. 90% hormone treatments prove to be effective in eliminating symptoms with in several months. However the relapse incidence of this disease is as high as 60%,
Mesangial proliferative Glomerulonephritis is featured by various degree of Mesangial cellular proliferation and Mesangial matrix increase. this disease is usually caused by infections, and the following deposition of immune complex in Mesangial area lead to pathological changes of Mesangial cells.
Mesangial capillary nephritis accounts for nearly 10% of all primary nephritis. The curing of this disease is not easy. 20%-30% Mesangial capillary nephritis Immunotherapy from infection of upper respiratory tract. This disease is featured by serious ischemia which can be discordant with decline of renal function.
Membranous Nephropathy commonly occurs to middle-aged and the aged. This disease is caused by deposition of immune complex which fall off the glomerular epithelial cells. Membranous nephropathy usually has little relationship with infection. The curing of this disease is time consuming.
Focal segmental glomerulosclerosis(FSGS) means that there is partial glomerular cells are damaged and cellular Mesangial sclerosis occurs. This disease can lead to massive protein leakage.

All in all Nephritic Syndrome is featured by massive protein leakage, edema, hyperlipemia and hypoproteinemia. And the pathological diagnosis of nephritic syndrome is also important for the adoption of proper treatments.