Nephritic syndrome awareness

Overview

Nephritic syndrome is a kidney condition where the tiny filters inside your kidneys (called glomeruli) become inflamed and damaged. This inflammation causes blood and protein to leak into your urine, and your kidneys may not work as well as they should. It is not the same as nephrotic syndrome, which involves much larger amounts of protein leaking.

Nephritic syndrome is not a common condition, but it is one of the most common causes of sudden kidney problems in children and young adults. It happens more often in certain parts of the world where infections are more frequent.

Nephritic syndrome can affect people of any age, but it is most common in children aged 2 to 12 and in young adults. It sometimes follows an infection, especially strep throat or a skin infection. It can also affect older adults, especially those with other health conditions like diabetes or high blood pressure.

Symptoms

Common symptoms

• Blood in your urine, which may look pink, red, or brown (like cola or tea)
• Foamy or bubbly urine (due to protein)
• Less urine than usual
• Swelling in your face, around your eyes, in your hands, feet, or ankles
• High blood pressure

Symptoms in children

• Children may have a fever, joint pain, or a sore throat before the kidney symptoms start.
• They might complain of belly pain or pain in the side (flank pain).
• Swelling around the eyes is often more noticeable in the morning.

Symptoms in older adults

• Older adults may have less obvious swelling but more problems with high blood pressure.
• They might feel more tired or weak than usual.
• Sometimes the urine changes are harder to notice.

Causes

Main causes

• Infections, especially strep throat (Group A Streptococcus) or a skin infection (impetigo)
• Autoimmune diseases, where your body's immune system attacks your own kidneys, such as IgA nephropathy or lupus
• Vasculitis — inflammation of the blood vessels that can affect the kidneys
• Some other infections, like hepatitis B or C, or HIV

Risk factors

• Recent bacterial infection, especially strep throat or skin infection
• Having an autoimmune condition like lupus or IgA nephropathy
• Family history of kidney disease
• Being a child or young adult (for post-streptococcal nephritic syndrome)

When to see a doctor

See a doctor urgently if:

• If you notice blood in your urine — even if it only happens once
• If you have sudden swelling in your face, hands, or feet
• If you are urinating much less than usual

Book a routine appointment if:

• If you have ongoing high blood pressure, even without other symptoms
• If you have a known kidney condition and need regular check-ups

Diagnosis

Your doctor will start by asking about your symptoms and recent infections. They will check your blood pressure and look for swelling. Then they will order urine and blood tests to check your kidney function and look for signs of inflammation.

Tests that may be done

• Urine test (dipstick and microscopy) to check for blood, protein, and casts (a sign of inflammation)
• Blood test to measure creatinine and estimate your glomerular filtration rate (eGFR) — this tells how well your kidneys are filtering
• Blood test for antibodies like antistreptolysin O (ASO) if a strep infection is suspected
• Ultrasound of your kidneys to check their size and shape
• Kidney biopsy (taking a tiny sample of kidney tissue) sometimes needed to confirm the cause

What to expect at your appointment

You may need to give a urine sample and have blood taken. An ultrasound is painless and takes about 30 minutes. If a kidney biopsy is needed, you will be given a local anaesthetic to numb the area, and a small needle is used to remove a tiny piece of kidney tissue. You will be monitored for a few hours afterwards. The results help your doctor choose the best treatment.

Treatment

Treatment for nephritic syndrome focuses on the cause of the inflammation, managing symptoms, and protecting your kidneys from further damage. Many people improve within a few weeks, especially if the cause is an infection that is treated. You may need to be in the hospital for the first few days, especially if your blood pressure is very high or you have swelling.

Self-care at home

• Follow a low-salt diet to help control swelling and blood pressure
• Drink enough fluids to stay hydrated, but do not overdo it — follow your doctor's advice on fluid intake
• Monitor your blood pressure at home if your doctor recommends it
• Weigh yourself daily to check for sudden fluid gain

Medical treatments

Doctors will treat the underlying cause. For example, if a bacterial infection is causing the problem, they will prescribe antibiotics. To control high blood pressure, they use medications that also help protect the kidneys, such as ACE inhibitors or ARBs. If an autoimmune condition is the cause, they may use steroids or other medicines to reduce inflammation. You may also be given diuretics (water pills) to help remove extra fluid and reduce swelling.

When is surgery considered?

Surgery is not a standard treatment for nephritic syndrome. In very rare cases, if the kidney injury is severe and leads to kidney failure, you might need dialysis or a kidney transplant, but this is not surgery for the nephritic syndrome itself.

Living with this condition

Living with nephritic syndrome means paying attention to your body and following your treatment plan. Most people feel better within a few weeks, but it can take months to fully recover. You may need to see your doctor regularly for check-ups and have blood and urine tests to monitor your kidneys.

Lifestyle tips

• Take all medicines exactly as prescribed, and tell your doctor about any side effects
• Avoid over-the-counter painkillers like ibuprofen or naproxen unless your doctor says it is safe — these can harm your kidneys
• Stay active with gentle exercise like walking, but rest when you feel tired
• Avoid smoking and limit alcohol

Diet and exercise

Your doctor may recommend a low-salt diet to control blood pressure and swelling. Limit processed foods, canned soups, and salty snacks. You may also need to watch your protein intake if your kidney function is low. Exercise is generally good, but start slowly and listen to your body. If you feel very tired or have joint pain, rest.

Mental health and emotional wellbeing

Having a kidney condition can be worrying. You may feel anxious about your health or about the future. It is normal to feel upset or stressed. Talk to your family, friends, or a counsellor about how you are feeling. If you feel overwhelmed, ask your doctor about mental health support.

Prevention

Not all cases of nephritic syndrome can be prevented, but you can reduce your risk by treating infections promptly and controlling chronic conditions like high blood pressure. Good hygiene (washing hands, cleaning cuts) can help prevent skin infections that sometimes trigger the condition.

Vaccines

Keep your vaccinations up to date, especially the flu shot and pneumonia vaccine. These help prevent infections that could trigger kidney problems. Talk to your doctor about which vaccines are right for you.

Screening programmes

If you have a condition that raises your risk (like lupus or IgA nephropathy), your doctor may recommend regular urine and blood tests to catch kidney problems early. There is no routine screening for the general public.

Complications

If left untreated

• Chronic kidney disease — long-term damage that may get worse over time
• High blood pressure that is hard to control
• Kidney failure — needing dialysis or a transplant
• Fluid buildup that can cause heart failure or breathing problems
• Increased risk of infections

Long-term outlook

The outlook for nephritic syndrome is often very good, especially when it is caused by an infection and treated early. Most people recover fully within a few weeks to months. However, some people may have long-term kidney damage that needs ongoing care. With modern treatments, even those who develop chronic kidney disease can lead full, active lives. Your healthcare team will work with you to manage your condition and keep your kidneys as healthy as possible.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.