Differences between nephritic and nephrotic diseases. Variations in presentation need to be expected in patients presenting with the underlying diseases. This refers to the ‘standard’ presentation of a patient, but note that there are exceptional cases (ie, patients with severe lupus nephritis and acute kidney failure).
| Nephritic syndrome | Nephrotic syndrome | |
| Onset | Mainly abrupt | Insidious-abrupt |
| Kidney function | Variable, from no/slow progression (many cases with IgA nephropathy) to RPGN | Mainly no significant kidney function impairment at baseline |
| Proteinuria | Variable, absent in some patients | ‘Nephrotic-range’ (>3–3.5 g/day, depending on definitions) proteinuria seen in most cases |
| Haematuria | Feature of ‘nephritis’; gross haematuria (visible blood) only in a minority of cases | Variable, absent in most patients |
| Blood pressure | Raised (most cases), patients often remain hypertensive (even after achieving remission) | Normal/raised (hypertensive often because of fluid overload) |
| Serum albumin | Normal/low | Low (in ‘idiopathic’ cases), <2.5 g/dL |
| Hypercoagulability | Present in some forms (ie, AAV) | Present in nephrotic stages (up to 40% with thrombosis) |
| Lipid levels | No change/reduced during active stages | Hyperlipidaemia |
AAV, ANCA-associated vasculitis; RPGN, rapidly progressive glomerulonephritis.