1. Nephritic and nephrotic syndromes

2. Nephritic syndrome Haematuria (red or brown urine)
Oedema and generalised fluid retention
Hypertension
Oliguria

3. The complete form is classically seen in post-infectious glomerulonephritis, may occur in acute IgA nephropathy, and occasionally occurs in other types of glomerulonephritis. The presence of one or more features is common to many types of glomerular disease.

4. Nephrotic syndrome
Nephrotic syndrome refers to the secondary phenomena that occur when substantial amounts of protein are lost in the urine

5. Overt proteinuria: usually > 3.5 g/24 hrs (urine may be frothy)
Hypoalbuminaemia (< 30 g/L)
Oedema and generalised fluid retention
Intravascular volume depletion with hypotension, or expansion with hypertension, may occur

6. Classically seen in non-inflammatory and subacute inflammatory/proliferative glomerular disorders

7. Consequences of the nephrotic syndrome and their management
Hypoalbuminaemia
Urinary protein losses exceed synthetic capacity of liver leads to reduced oncotic pressure & oedema ( can be managed by diuretics and a low-sodium diet ).

8. Avid sodium retention
Secondary hyper-aldosteronism &   additional poorly characterised intra-renal mechanisms lead to oedema . 

9. Hypercholesterolaemia
Non-specific increase in lipoprotein synthesis by liver in response to low oncotic pressure with a consequence of high rate of atherosclerosis that can be managed by Lipid-lowering drugs (e.g. HMG CoA reductase inhibitors).

10. Hypercoagulability
Relative loss of inhibitors of coagulation (e.g. antithrombin III, protein C and S) and increase in liver synthesis of procoagulant factors lead to venous thromboembolism so we must consider prophylaxis in all patients with chronic or severe nephrotic syndrome.

11. Infection
Hypogammaglobulinaemia (urinary losses) leads to Pneumococcal infection( Consider vaccination).

12. Thank you