VHOSPITAL.CLINIC · Differential Diagnosis
Glomerulonephritis vs Nephrotic Syndrome
Clinical comparison — shared symptoms, key differences, distinguishing diagnostic tests, treatment pathways, and when to seek urgent evaluation.
Condition Overview
Condition A
Glomerulonephritis
Glomerulonephritis is inflammation of the glomeruli causing hematuria, proteinuria, hypertension, and impaired kidney function. It can be acute (post-streptococcal) or chronic; IgA nephropathy is the most common form worldwide.
Condition B
Nephrotic Syndrome
Nephrotic syndrome is characterized by massive proteinuria (>3.5g/day), hypoalbuminemia, edema, and hyperlipidemia. Causes include minimal change disease (children), membranous nephropathy, and diabetic nephropathy; steroids and immunosuppressants are used.
Shared Symptoms — Why They're Confused
Both conditions present with 3 overlapping symptoms, making clinical differentiation essential.
Key Clinical Differences
Glomerulonephritis
- Haematuria (cola-coloured urine), hypertension, mild proteinuria
- Reduced GFR, RBC casts in urine
- Presents acutely; post-infectious (APSGN) or autoimmune (IgA nephropathy)
- Oedema may be absent or mild
Nephrotic Syndrome
- Heavy proteinuria (>3.5 g/day), hypoalbuminaemia, severe oedema
- No haematuria (or minimal)
- Hyperlipidaemia and lipiduria
- Causes: minimal change, FSGS, membranous nephropathy
Distinguishing Diagnostic Tests
| Test | Glomerulonephritis | Nephrotic Syndrome |
|---|---|---|
| Urinalysis | Dysmorphic RBCs and RBC casts — nephritic sediment | Heavy proteinuria (dipstick 3–4+), lipiduria; no significant haematuria |
| Urine protein:creatinine ratio | Mild-moderate proteinuria (<3 g/day) | Nephrotic-range proteinuria >3.5 g/24 h |
| Serum albumin | Near normal or mildly reduced | Severely reduced (<25 g/L) — drives oedema formation |
Treatment Approaches
Glomerulonephritis
- •Treat underlying cause (steroids for lupus nephritis, ACEi for IgA)
- •Blood pressure control
- •Dialysis if rapidly progressive GN
Nephrotic Syndrome
- •High-dose corticosteroids (minimal change disease)
- •Cyclophosphamide or mycophenolate for FSGS/membranous
- •Diuretics for oedema; statins for hyperlipidaemia
When Doctors Consider Each Diagnosis
🔵 Consider Glomerulonephritis when:
- →Haematuria, RBC casts, hypertension, moderate proteinuria
🟢 Consider Nephrotic Syndrome when:
- →Heavy proteinuria, hypoalbuminaemia, severe oedema, no significant haematuria
Explore Each Condition in Detail
Related Clinical Pages
Glomerulonephritis
Medical References
Content on this page is informed by evidence-based clinical sources including:
- World Health Organization (WHO)Global health guidance and disease classification
- National Health Service (NHS)UK clinical guidelines and patient information
- National Institute for Health and Care Excellence (NICE)Evidence-based clinical practice guidelines
- Centers for Disease Control and Prevention (CDC)US public health data and clinical recommendations
- PubMed – NCBIPeer-reviewed biomedical literature and clinical studies
- Cochrane LibrarySystematic reviews and meta-analyses in evidence-based medicine
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