GuidelinesPrimary Care STG
Nephritic Syndrome
Glomerular disease
N05.9
DESCRIPTION
Presents with a varied combination of:
- Painless, turbid, brownish, or macroscopically bloody urine.
- Peripheral and periorbital oedema.
- Pulmonary oedema (circulatory overload).
- Hypertension or hypertensive encephalopathy with impaired level of consciousness or convulsions.
- Little or no urine excretion.
In children, this is commonly due to acute post streptococcal glomerulonephritis.
GENERAL MEASURES
- Give oxygen, and nurse in Semi-Fowlers position if patient has respiratory distress.
- Early referral essential, especially if patient had a hypertensive episode or fluid overload.
- If dehydrated or shocked: Treat immediately. (See: Shock).
- The definitive treatment of nephritis depends on the cause – an assumption of acute post streptococcal nephritis or any other disease cannot be made without specific investigation which may include renal biopsy.
MEDICINE TREATMENT
- For management, see: Acute kidney injury.
REFERRAL
- All cases.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_17 October 2024
Chapter 8: Kidney and Urological Disorders_8.3 Glomerular Diseases (GN)_8.3.1 Nephritic Sydrome