Merck Manual

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Overview of Nephritic Syndrome


Frank O'Brien

, MD, Washington University in St. Louis

Last review/revision Jul 2021 | Modified Sep 2022
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Nephritic syndrome is defined by hematuria, variable degrees of proteinuria, usually dysmorphic red blood cells (RBCs), and often RBC casts on microscopic examination of urinary sediment. Often 1 of the following elements are present: edema, hypertension, elevated serum creatinine, and oliguria. Nephritic syndrome has both primary and secondary causes. Diagnosis is based on history, physical examination, and sometimes renal biopsy Renal biopsy Biopsy of the urinary tract requires a trained specialist (nephrologist, urologist, or interventional radiologist). Indications for diagnostic biopsy include unexplained nephritic or nephrotic... read more . Treatment and prognosis vary by cause.

Nephritic syndrome is a manifestation of glomerular inflammation (glomerulonephritis) and occurs at any age. Causes differ by age (see table Glomerular Disorders by Age and Presentation Glomerular Disorders by Age and Manifestations Glomerular Disorders by Age and Manifestations ), and mechanisms differ by cause. The syndrome can be

  • Acute (serum creatinine rises over many weeks or less)

  • Chronic (renal insufficiency may progress over years)

Nephritic syndrome can also be

  • Primary (idiopathic)

  • Secondary


Acute glomerulonephritis

Chronic glomerulonephritis

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