Hypertension in nephritic vs nephrotic syndrome

[Daitong]

Hi all,

So some of the defining characteristics of nephritic syndrome include oliguria, azotemia, hematuria, and hypertension; could someone explain to me the pathophysiology behind HTN and why it's not as prominent as in nephrotic syndrome?

It is my understanding that due to the albumin loss of nephrotic syndrome we get a more generalized and severe edema, but because that fluid is not in the vascular space we don't get HTN, but I'm still not understanding why nephritic syndrome results in HTN.

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[chillaxbro]

Probably just RAAS activation? Why it is more than the other I dunno (wasn't aware that was true)

 

[iceman55]

Hi all,

So some of the defining characteristics of nephritic syndrome include oliguria, azotemia, hematuria, and hypertension; could someone explain to me the pathophysiology behind HTN and why it's not as prominent as in nephrotic syndrome?

It is my understanding that due to the albumin loss of nephrotic syndrome we get a more generalized and severe edema, but because that fluid is not in the vascular space we don't get HTN, but I'm still not understanding why nephritic syndrome results in HTN.

Aren't you a first year man? Go chill out, go to happy hour or something.

But anyways, it's due to sodium retention.


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[Entadus]

For nephritic syndrome: Oliguria means low urine output... GFR and V-dot (urinary flow rate) would both be low... leading to fluid retention -> hypertension (This is not a majorly important phenomenon)

For nephrOtic syndrome: loss of albumin leads to lowered oncotic pressure, causing anasarca (generalized edema) as fluid leaves the vasculature to enter the interstitial spaces. Activation of Renin-Angiotensin-Aldosterone along with ADH action would promote sodium/fluid retention as well as sympathetic activation, causing the hypertension.