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Friday, March 19, 2010

Nephrotic VS Nephritic - where one letter makes a world of a difference

Back when I was a medical student, I thought my nephrology lecturer was a fickle dyslexic - which explained why he kept flitting between nephritic and nephrotic in his lecture notes.  And I wonder why I never really grasped either syndrome until now... ...

Features of nephrotic syndrome - "NAPHROTIC"
Na+  - you may rarely get hyponatremia in nephrotic syndrome; this is also a reminder that there is an intense pathophysiologic retention of sodium due to reduced oncotic pressure
Albumin - serum levels are decreased
Proteinuria >3g/day
Hyperlipidemia
Renal vein thrombosis
Oedema
Thrombosis
Infections - more prone to them due to loss of Ig in the urine
Coaguability

Features of nephritic syndrome - "HO HO"
Hematuria - not forgetting the all-important RED CELL CASTS
Oedema
Hypertension
Oliguria (secondary to developing azotemia) 

Admittedly, the 2nd mnemonic is pretty weak =P
I guess the take home point is to be aware of the complications that can arise in patients with nephrotic-range proteinuria.  On the other hand, one needs to be very wary of deteriorating renal function in patients who develop red-cell casts.

2 comments:

Unknown said...

Better mnemonic for Nephritic = "PHAROH" - Proteinuria, Haematuria, Azotaemia, RBC casts, Oedema/Oliguria, Hypertension

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