Nephrotic Syndrome vs. Glomerulonephritis

What is the KEY difference between acute glomerulonephritis and nephrotic syndrome?

• Glomerulonephritis: inflammation → RBCs + mild protein leak

• Nephrotic syndrome: glomerular damage → massive protein loss ONLY ⭐

Which condition causes hematuria (blood in urine)?

• Glomerulonephritis ⭐

• Due to inflamed glomerulus → RBCs leak through

Which condition causes massive proteinuria?

• Nephrotic syndrome ⭐

• Large amounts of protein lost (>3 g/day)

What is happening in acute glomerulonephritis?

• Inflammation of glomeruli

• Caused by antigen-antibody complexes

• Glomerulus becomes permeable → RBCs + protein leak

What is the most common cause of acute glomerulonephritis?

• Post-streptococcal infection ⭐

• Occurs ~2 weeks after infection

What is happening in nephrotic syndrome?

• Damage to glomerulus

• Causes massive protein loss (especially albumin)

• Cause often idiopathic

What is a common cause of nephrotic syndrome in children?

Minimal change disease ⭐

What are hallmark signs of acute glomerulonephritis?

• Hematuria → tea/cola urine ⭐

• Hypertension ⭐

• Decreased GFR

• Oliguria

• Mild edema (face, eyes)

• ↑ BUN & creatinine

Why does hypertension occur in glomerulonephritis?

↓ GFR → fluid retention → ↑ blood volume → ↑ BP

Why is urine output decreased in glomerulonephritis?

Inflamed glomerulus → ↓ filtration → ↓ urine

Why is hyperkalemia a risk in glomerulonephritis?

• Kidneys cannot excrete potassium → builds up in blood ⭐

What are hallmark signs of nephrotic syndrome?

• Massive proteinuria ⭐

• Hypoalbuminemia ⭐

• Severe edema ⭐

• Hyperlipidemia

• Frothy/foamy urine

Why does edema occur in nephrotic syndrome?

• ↓ albumin → ↓ oncotic pressure

• Fluid shifts into tissues → edema

Why do nephrotic patients have hyperlipidemia?

Liver compensates for low albumin → produces lipids

Why are nephrotic patients at risk for infection?

Loss of immunoglobulins in urine

Why are nephrotic patients at risk for clots?

Loss of proteins that prevent clotting → ↑ clot risk ⭐

How can you quickly differentiate glomerulonephritis vs nephrotic syndrome?

• Glomerulonephritis:

  • Blood in urine

  • HTN

  • ↓ urine

• Nephrotic:

  • Protein loss

  • Massive edema

  • Frothy urine

What are priority nursing interventions for glomerulonephritis?

• Monitor BP ⭐

• Strict I&O

• Monitor potassium ⭐

• Fluid & sodium restriction

• Monitor renal function

What should the nurse monitor closely related to urine output?

• At least 30 mL/hr (adult)

• Or 1 mL/kg/hr (child)

What are priority nursing interventions for nephrotic syndrome?

• Monitor edema & weight ⭐

• Give albumin + diuretics ⭐

• Monitor for infection

• Monitor for clots ⭐

• Sodium & fluid restriction

Why are albumin and diuretics given together?

• Albumin pulls fluid back into vessels

• Diuretics remove that fluid → ↓ edema

What medication is commonly used for nephrotic syndrome?

• Corticosteroids ⭐

• Reduce protein loss and relapse

What are the biggest test clues for each condition?

• Glomerulonephritis:

  • “Recent strep”

  • Tea-colored urine

  • HTN

• Nephrotic:

  • Massive edema

  • Frothy urine

  • Low albumin

A child presents with tea-colored urine and a recent history of strep throat. Which condition is most likely?

A. Nephrotic syndrome
B. Acute glomerulonephritis
C. Pyelonephritis
D. Chronic kidney disease

B. Acute glomerulonephritis

Rationale:

• Tea-colored urine = hematuria

• Recent strep = classic cause

• This is hallmark of glomerulonephritis

A nurse is assessing a client with nephrotic syndrome. Which findings should the nurse expect? (Select all that apply)

A. Massive proteinuria
B. Hypoalbuminemia
C. Hematuria
D. Edema
E. Hyperlipidemia

A, B, D, E

Rationale:

• Nephrotic = protein loss disorder

• Hematuria is NOT typical

• Edema + low albumin = key features

A nurse is caring for a client with glomerulonephritis. Which finding requires immediate intervention?

A. Tea-colored urine
B. Potassium 6.1 mEq/L
C. Mild edema
D. Elevated creatinine

B. Potassium 6.1 mEq/L

Rationale:

• Hyperkalemia → life-threatening dysrhythmias ⭐

• Always priority

Which finding is most specific to nephrotic syndrome?

A. Hypertension
B. Tea-colored urine
C. Frothy urine
D. Decreased GFR

C. Frothy urine

Rationale:

• Frothy urine = proteinuria ⭐

• Signature sign of nephrotic syndrome

A nurse is caring for a client with nephrotic syndrome. Which intervention is appropriate?

A. Restrict protein intake
B. Administer albumin and diuretics
C. Encourage high sodium diet
D. Monitor for hematuria only

B. Administer albumin and diuretics

Rationale:

• Albumin restores oncotic pressure

• Diuretics remove fluid

• Key treatment combo ⭐

Which condition is MOST associated with hypertension?

A. Nephrotic syndrome
B. Acute glomerulonephritis
C. Peritoneal dialysis
D. Minimal change disease

B. Acute glomerulonephritis

Rationale:

• HTN = classic with glomerulonephritis

• Nephrotic → edema > HTN

🔥 FINAL TIP (THIS WILL SHOW UP ON YOUR TEST)

👉 Blood = glomerulonephritis
👉 Protein = nephrotic syndrome
👉 HTN = glomerulonephritis
👉 Massive edema = nephrotic syndrome