acute

Nephritic Syndrome (Referral)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

KDIGO Clinical Practice Guideline for Glomerular Diseases 2021 · Egyptian National Drug Formulary - Cardiovascular 2024 (furosemide monograph) · Egyptian National Drug Formulary - Cardiovascular 2024 (amlodipine monograph)

Verified against2 documents

Egyptian National Drug Formulary - Cardiovascular 2024 (furosemide monograph)
Egyptian National Drug Formulary - Cardiovascular 2024 (amlodipine monograph)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (6)

Morning puffiness around the eyes and evening leg swelling are reported [leg swelling]
Cola-colored or red urine points to hematuria [blood in the urine]
Foamy urine occurs when protein content is high, though proteinuria stays under 3.5 g/day [proteinuria]
Reduced urine output points to renal insufficiency
A recent throat or skin infection, fever, or fatigue should be asked about [fatigue · fever]
Coughing up blood with breathlessness may point to Goodpasture syndrome or Wegener granulomatosis [breathlessness · coughing up blood]

Signs — what you find (5)

Elevated blood pressure is a common vital sign finding [hypertension]
JVP distension, pitting edema, and lung crackles reflect fluid overload [crackles · leg swelling]
A new heart murmur raises suspicion for infective endocarditis [heart murmur]
Palpable purpura with swollen joints suggests a systemic vasculitic cause [purpura · rash]
Pallor and anemia may be found on exam [anaemia · pallor]

Tests (9)

Nephritic urine shows over 5 RBCs per HPF with dysmorphic cells and RBC casts
At least 1 in 20 red cells being an acanthocyte confirms a glomerular source of hematuria
Proteinuria is usually under 3.5 g/day but can reach the nephrotic range
Elevated creatinine with reduced GFR reflects impaired filtration
Kidney biopsy establishes the definitive underlying cause
Low C3/C4 complement points to immune-complex disease such as post-streptococcal GN or SLE
High ASO or anti-DNase B titers indicate a recent streptococcal infection
ANCA testing screens for systemic vasculitis such as granulomatosis with polyangiitis
Anti-GBM antibodies are checked to exclude Goodpasture syndrome

If not this — what else fits (2)

Nephrotic syndrome and familial nephritis are considered on the differential
Idiopathic hematuria and anaphylaxis are also listed as differentials

SourceStatPearls "Nephritic Syndrome" - disease-level clinical article

Presentation findings are traced to the source above.

FUROSEMIDE

1st line

Strength40 mg

Formoral.solid

Adult dose and duration

Oral: Initial: 20-50 mg once then titrate as needed to achieve targeted effect.

Paediatric dose

1-2 mg/kg/dose [child max 40 mg]

(Acute: Initial: 2 mg/kg as a single dose; if ineffective, may increase in 6 to 8 hours in increments of 1 to 2 mg/kg/dose; maximum dose: 6 mg/kg/dose.)

Dose by weight
3kg	3-6 mg/dose
4kg	4-8 mg/dose
5kg	5-10 mg/dose
6kg	6-12 mg/dose
7kg	7-14 mg/dose
8kg	8-16 mg/dose
9kg	9-18 mg/dose
10kg	10-20 mg/dose
11kg	11-22 mg/dose
12kg	12-24 mg/dose
13kg	13-26 mg/dose
14kg	14-28 mg/dose
15kg	15-30 mg/dose
16kg	16-32 mg/dose
17kg	17-34 mg/dose
18kg	18-36 mg/dose
19kg	19-38 mg/dose
20kg	20-40 mg/dose
21kg	21-40 mg/dose (upper capped)
22kg	22-40 mg/dose (upper capped)
23kg	23-40 mg/dose (upper capped)
24kg	24-40 mg/dose (upper capped)
25kg	25-40 mg/dose (upper capped)
26kg	26-40 mg/dose (upper capped)
27kg	27-40 mg/dose (upper capped)
28kg	28-40 mg/dose (upper capped)
29kg	29-40 mg/dose (upper capped)
30kg	30-40 mg/dose (upper capped)
31kg	31-40 mg/dose (upper capped)
32kg	32-40 mg/dose (upper capped)
33kg	33-40 mg/dose (upper capped)
34kg	34-40 mg/dose (upper capped)
35kg	35-40 mg/dose (upper capped)
36kg	36-40 mg/dose (upper capped)
37kg	37-40 mg/dose (upper capped)
38kg	38-40 mg/dose (upper capped)
39kg	39-40 mg/dose (upper capped)
40kg	40 mg/dose (capped)
41kg	40 mg/dose (capped)
42kg	40 mg/dose (capped)
43kg	40 mg/dose (capped)
44kg	40 mg/dose (capped)
45kg	40 mg/dose (capped)
46kg	40 mg/dose (capped)
47kg	40 mg/dose (capped)
48kg	40 mg/dose (capped)
49kg	40 mg/dose (capped)
50kg	40 mg/dose (capped)

Dose source

Egyptian National Drug Formulary - Cardiovascular 2024 (furosemide monograph)

Why

Loop diuretic that controls the fluid overload driving edema and hypertension in nephritic syndrome while urgent nephrology referral is arranged.

Cautions

Characterized by hematuria, oliguria, hypertension, and facial edema (often post-streptococcal).
Monitor serum potassium, renal function, and fluid balance closely.
Anuria
Urgent nephrology referral is required.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
ODEMENT 40MG 10 TAB.	EL NASR	1.30 EGP (0.13/unit)
FRUZEX 40MG 12 TAB.	MISR	3.25 EGP (0.27/unit)
FUROSEMIDE 40MG 20 TAB.	SEDICO	7.50 EGP (0.38/unit)
FURORETIC 40 MG 30 TABS.	DEBEIKY > VETOPHARM	14.25 EGP (0.47/unit)
LAFUREX 40MG 20 TAB.	AMOUN	9.50 EGP (0.47/unit)
SALEX 40 MG 20 TABS.	ARAB DRUG COMPANY (ADCO)	10.00 EGP (0.50/unit)
FUROSEMIDE-ALEX 40MG 20 TAB.	ALEXANDRIA	19.00 EGP (0.95/unit)
LASIX 40 MG 24 TABS.	SANOFI	30.00 EGP (1.25/unit)
GENESEMIDE 20MG/5ML SYRUP 120 ML? strength differs? different route - not oral solid	MEDIZEN PHARMACEUTICAL INDUSTRIES > VODACHEM	56.00 EGP

AMLODIPINE

add-on - not a substitute

Strength5 mg

Formoral.solid

Adult dose and duration

Oral: Initial: 2.5 to 5 mg once daily; evaluate response after 2 to 4 weeks and titrate dose, as needed, up to a maximum of 10 mg once daily

Paediatric dose

Specialist pediatric nephrology management

Dose source

Egyptian National Drug Formulary - Cardiovascular 2024 (amlodipine monograph)

Why

Calcium-channel blocker added to diuretic therapy for acute blood pressure control, not a replacement for urgent nephrology referral; preferred over ACE inhibitors at this acute stage because it does not compromise renal perfusion.

Cautions

Monitor blood pressure closely.
Preferred over ACE inhibitors in acute kidney injury stage due to stable hemodynamics.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
CORONAVINE 5 MG 10 TAB.	PHAROPHARMA	6.00 EGP (0.60/unit)
WINDIPINE 5 MG 30 TAB.	SANOFI	21.00 EGP (0.70/unit)
VASOPINE 5 MG 30 TABS.	ARAB DRUG COMPANY (ADCO)	24.00 EGP (0.80/unit)
AMILO 5 MG 30 TAB.	ALFACURE PHARMACEUTICALS	54.00 EGP (1.80/unit)
AMLODIPINE 5 MG 30 TAB.	AMRIYA	60.00 EGP (2.00/unit)
MYODURA 5 MG 30 TAB.	GLOBAL NAPI PHARMACEUTICALS > WOCKHARDT	69.00 EGP (2.30/unit)
NORVASC 5MG 10 TAB.	PFIZER > VIATRIS EGYPT	54.00 EGP (5.40/unit)
NORVASC 5MG 30 TAB.	PFIZER > VIATRIS EGYPT	162.00 EGP (5.40/unit)

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.