| Factor | Nephrosis (Nephrotic Syndrome) | Acute Poststreptococcal Glomerulonephritis (APSGN) |
|---|
| Illness type | Chronic | Acute |
| Illness course | Characterized by periods of exacerbations and remissions during many years | Predictable, self-limiting, typically lasting 4–10 days (acute edematous phase) |
| Cause | Unknown | Group A β-hemolytic streptococci |
| Age at onset | 2–4 years | Early school-age children; peaks at 6–7 years |
| Sex | More common among boys | More common among boys |
| Major signs and symptoms: |
| General | Syndrome with variable pathology: massive proteinuria, hypoalbuminemia, severe edema, hyperlipidemia | Hematuria, hypertension |
| Blood pressure | Normal or decreased | Elevated |
| Edema | Generalized and severe | Periorbital and peripheral |
| Proteinuria | Massive | Moderate |
| Serum protein level | Decreased (6.1–7.9 g/dL) | Slightly decreased |
| Serum lipid level | Elevated | Normal |
| Potassium level | Normal (3.5–5 mEq/L) | Increased |
 Treatment | Symptomatic—no known cure; prednisone, cyclophosphamide, furosemide | Penicillin (EES), hydralazine, furosemide (sources are divided regarding use of prophylactic antimicrobials) |
 Diet | Decrease sodium, increase protein (unless azotemia develops) | Decrease sodium, decrease potassium, decrease protein (if azotemia develops) |
| Fluid restrictions | Seldom necessary | Necessary if output is significantly reduced |
| Specific nursing care | Treat at home if possible; good skin care; prevent infection | Treat in hospital during acute phase; monitor vital signs, especially blood pressure; on discharge, stress need to restrict strenuous activity until microscopic hematuria is gone |
| Prognosis | Fair; subject to long-term steroid treatment and social isolation related to frequent hospitalizations/confinement during relapses; 20% suffer chronic renal failure | Good; stress that recurrence is rare because specific immunity is conferred |