Following a throat infection, a patient presents with facial puffiness and mild hypertension. Urinalysis shows red color, protein 1+, blood 3+, RBC casts present. What is the presumptive diagnosis?

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The scenario points to glomerular inflammation causing nephritic-type kidney disease. After a throat infection, periorbital puffiness and mild hypertension reflect salt and water retention from reduced glomerular filtration. The urine findings are the key: presence of red blood cells and especially red blood cell casts shows that the bleeding is originating from the glomeruli, not from the urinary tract downstream. This pattern is classic for glomerulonephritis, often a post-infectious (post-streptococcal) GN.

Protein is present but only modestly (proteinuria not in the nephrotic range), which fits nephritic syndrome rather than nephrotic syndrome, where proteinuria is heavy and edema arises mainly from hypoalbuminemia. Acute tubular necrosis would typically produce granular casts and a different clinical picture, while pyelonephritis usually presents with fever and flank pain and shows white blood cell–related findings rather than prominent RBC casts from glomerular bleeding.