What Are Nephrotic and Nephritic Syndrome? - Signs & Consequences

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  • 0:02 When a Filter Is Damaged
  • 0:51 Nephrotic Syndrome
  • 4:13 Nephritic Syndrome
  • 5:59 Treatment of Both Syndromes
  • 6:33 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson will discuss two syndromes associated with diseases that affect the filters inside of the kidneys, the glomeruli. These conditions are called nephrotic and nephritic syndrome.

When a Filter Is Damaged

If your car's air filter is damaged, then you would expect all sorts of dust to leak into the car's cabin. If your fridge's water filter is damaged, then it may leak odd-looking things into the water you are about to drink. Neither of these scenarios is very healthy. The first may cause you respiratory problems and the second one may cause you diarrhea.

By now you may already know that the kidneys filter your blood. Microscopically speaking, it is structures known as the glomeruli (singular 'glomerulus') inside of the kidney that perform the actual filtration. If they, like the car and fridge filter, are damaged, then they will leak stuff into your urine that normally shouldn't be there. We'll find out what those things are in just a little bit.

Nephrotic Syndrome

A glomerular disorder that causes hypoalbuminemia, proteinuria, and edema is known as nephrotic syndrome. All sorts of glomerulopathies (diseases of the glomerulus) can result in nephrotic syndrome, including:

  • Minimal change disease
  • Focal segmental glomerulosclerosis
  • Membranous nephropathy
  • Diabetic nephropathy

I don't want you to really get bogged down in remembering the causes of nephrotic syndrome so much as understanding what actually happens. Any of those diseases damage the glomerulus. The glomerulus is the filter that is supposed to keep large things, such as proteins, inside of the blood while filtering out smaller toxins that get excreted in the urine. If the pores of the glomerulus, the little holes that allow for things to pass through the glomerulus and into the urine, are damaged, they get bigger. Bigger pores in any filter means that things that should've been kept out are now leaking into the urine and out of the blood.

You can reproduce this point at home. Take out some dirty old rag you no longer need. If you look really closely, you will see that there are small holes in the rag. They're truly tiny. This rag will represent our glomerulus, the filter. Turn on the faucet in a sink and place a couple of golf balls or something similar into the rag. Now place all of this under the running faucet. You'll note that the golf balls aren't filtered through, but the water and all the microscopic parts of it easily pass through to the other side.

Now go ahead and cut some big holes into the rag, mimicking the damage glomerulopathies cause. Repeat what you did before. This time around, not only will the water leak through but the golf balls will pass through as well.

In the case of nephrotic syndrome, a protein called albumin is like a golf ball that leaks out of the blood and into urine when it normally shouldn't. This leakage results in decreased levels of albumin in the blood, termed hypoalbuminemia, and increased levels of protein in the urine, known as proteinuria. Proteinuria during nephrotic syndrome is in the range of three grams per day or more. This is in contrast to other causes of proteinuria, such as a kidney infection, which results in less than that (up to two grams per day, normally).

You should note that the protein albumin, now leaking out of blood and into the urine, is important in keeping fluid within the blood vessels and out of the body tissues. Albumin is like a sponge that sucks up water into the vasculature. Since there's less albumin in the blood during nephrotic syndrome, there are fewer sponges in the blood vessels. This means water leaks out of the blood vessels and into the tissues. This is what is known as edema. Edema causes a person to literally swell up with fluid.

Nephritic Syndrome

Similarly to nephrotic syndrome is something called nephritic syndrome. This is a consequence of glomerular inflammation (known as glomerulonephritis) that results in hematuria, proteinuria, and hypertension. Here our glomerulus is damaged due to an inflammatory process. The ending '-itis' refers to inflammation and is why 'nephritic' has the suffix '-itic' in it. Glomerulonephritis leading to nephritic syndrome can result from infection (such as a streptococcal infection) or autoimmune disease (such as lupus). Sometimes the cause is actually unknown.

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