Nephritic Syndrome

Nephrology

Haematuria + hypertension + proteinuria (usually <3 g) + AKI.

History taking

  • Onset, duration, progression, severity
  • Aggravating / relieving factors
  • Past history, drugs, allergies, comorbidities
  • Family & social history relevant to presentation

Examination

  • General: vitals, pallor, icterus, oedema, lymphadenopathy
  • Focused system examination
  • Look for red-flag findings

Red flags

  • RPGN — refer same day

Differential diagnosis

  • See differentials section per chief complaint

Recommended investigations

  • Urinalysis (dysmorphic RBC, RBC casts), ACR
  • Complement, ANCA, anti-GBM, ANA, ASO
  • USS kidneys, biopsy

Diagnosis

  • Clinical diagnosis supported by targeted investigations

Initial treatment / management

  • Treat underlying cause
  • Symptomatic relief
  • Patient education

Follow-up advice

  • Review in 2–4 weeks or earlier if worsening
  • Monitor response to therapy and adverse effects

Patient counselling

  • Explain diagnosis and natural course in lay terms
  • Red-flag symptoms warranting urgent return
  • Adherence to medications and follow-up

Referral criteria

  • Refer if diagnostic uncertainty, complications, or failure of first-line therapy

References

  • Harrison's Principles of Internal Medicine, 21e
  • NICE / WHO guidelines (current edition)

Educational outpatient guide — verify against local guidelines before clinical use.

WardRound

WardRound

Clinical Decisions in Seconds