Nephritic Syndrome
Also known as: Rapidly progressive glomerulonephritis
What is it?
Rapidly progressive nephritic syndrome is an
inflammation of the kidneys that damages the kidney’s
filtering mechanisms, called the glomeruli. It is also
called rapidly progressive glomerulonephritis.
Who gets it?
Rapidly progressive nephritic syndrome is unusual, but
may be more likely to affect people with autoimmune
disorders.
What causes it?
In many cases, the cause of rapidly progressive
nephritic syndrome is unknown. In other cases, the cause
appears to be a malfunction of the immune system, which
could result from a virus or autoimmune disorder such as
systemic lupus erythematosus. The immune system produces
infection-fighting proteins, called antibodies, that
attack the glomeruli. In some patients, these antibodies
affect the kidneys and the lungs, causing a condition
called Goodpasture's syndrome.
What are the symptoms?
Rapidly progressive nephritic syndrome begins suddenly
and gets worse very quickly. Symptoms may be flu-like,
such as general fatigue, nausea, vomiting, loss of
appetite, fever, and abdominal and joint pain. These types
of symptoms can appear for up to one month before symptoms
of kidney failure appear. Patients whose kidneys are
failing will produce only small amounts of urine and have
swelling (edema) from fluid build-up. Additional symptoms
such as breathing difficulties and coughing up blood are
signs of Goodpasture’s syndrome.
How is it diagnosed?
To diagnose rapidly progressive nephritic syndrome,
your doctor will study your medical history and symptoms,
and perform a complete physical examination. Your doctor
will check a urine sample for signs of protein and blood,
because the damaged glomeruli allow these substances to
enter the urine. A blood test will reveal a low red blood
cell count (anemia) and a high white blood cell count.
Your doctor may also take a small sample of kidney tissue,
called a biopsy, to study under a microscope.
What is the treatment?
When rapidly progressive nephritic syndrome is caused
by an autoimmune disorder, treatment involves drugs that
suppress the immune system’s production of antibodies.
Drugs called corticosteroids, which reduce inflammation,
may also be used to treat the damaged glomeruli.
Corticosteroids are given intravenously, then orally, for
a specified period of time. Some patients may also need a
treatment called plasmapheresis, in which the blood is
filtered to remove the antibodies that are attacking the
glomeruli. The antibody-free blood is then returned to the
patient. Once kidney failure has occurred, waste products
must be removed from the bloodstream for the kidneys
through a process called dialysis. While a kidney
transplant may be considered as an option, there is no
guarantee that nephritic syndrome will not affect the new
kidney.
Self-care tips
Because the initial symptoms of rapidly progressive
nephritic syndrome are so general, many patients are not
diagnosed until their condition has progressed to kidney
failure. For this reason, it is important to see your
doctor whenever you have general symptoms such as fever,
weakness, and fatigue for no apparent reason.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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