What characterizes nephritic syndrome on urine analysis?

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Nephritic syndrome is characterized by the presence of hematuria, which often appears as red blood cell casts in the urine. The formation of these casts indicates that there is glomerular injury or inflammation, a hallmark of nephritic processes. This combination of hematuria and red blood cell casts is critical for diagnosing nephritic syndrome, differentiating it from other renal conditions.

In contrast, nephrotic syndrome, which significantly differs from nephritic syndrome, typically manifests with substantial protein loss in the urine, specifically over 3.5 grams per day. Sterile pyuria refers to the presence of white blood cells in the urine without an active urinary tract infection, and while it may appear in certain kidney disorders, it does not specifically characterize nephritic syndrome. Glucose presence in urine can indicate diabetes or tubular dysfunction but is not a defining feature of nephritic syndrome. Thus, the presence of hematuria with red blood cell casts aligns precisely with the pathophysiology of nephritic syndrome.

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