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differential management treatment algorithm syndrome microscopy workup aki rheumatology cns infectiousdiseases proteinuria renal syndromes urology barre blood classification cord endocarditis
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
“Muddy Brown” Casts ... B. slightly coarser ... of mb granular casts ... Granular #MuddyBrown #Casts ... #Clinical #Nephrology
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... chronic kidney diseases ... colored compounds (e.g ... #nephrology #interpretation ... #diagnosis
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... infection • Hyaline casts ... • Granular casts ... #nephrology #casts
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
repeat testing • Acute ... proteinuria, RBC casts ... → Refer to Nephrology ... cystoscopy • Refer to Nephrology ... if cause not identified
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
require urgent nephrology ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... for WBCs, RBCs, casts ... #nephrology
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... breakdown of cellular casts ... heme-granular casts ... edgarvlermamd - Nephrology ... #Nephrology
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
RBC casts in urine ... but in severe cases ... May be 10 (eg direct ... #Proteinuria #Nephrology ... #Diagnosis
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... - Differential Diagnosis ... sediment - WBC/RBC casts ... Minimal change disease ... #Proteinuria #Nephrology
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
basement membrane disease ... hematuria: - RBC casts ... of glomerular disease ... #causes #urology ... #nephrology #renal
Common causes of Acute Kidney Injury AKI - Differential Diagnosis HEMODYNAMIC • Cardiac failure: Impaired forward flow,
Common causes of ... - Differential Diagnosis ... • Primary GNs: Disease ... Due to systemic disease ... #nephrology
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