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management differential syndrome algorithm treatment microscopy video proteinuria workup aki barre criticalcare glomerular guillain nephrotic ophthalmology reflex syndromes anisocoria apex
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 ... suggestive of acute ... colored compounds (e.g ... #nephrology #interpretation ... #diagnosis
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
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... #nephrology #casts
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
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential Diagnosis ... sediment - WBC/RBC casts ... Protein deposition (eg ... #Proteinuria #Nephrology ... #Algorithm #Causes
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
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis Baseline Investigations: full blood count with differential,
Acute Kidney Injury ... and Differential Diagnosis ... osmolarity If cause ... investigations depending on clinical ... #nephrology #causes
Causes of Polyuria - Differential Diagnosis Algorithm Polyuria - Urine Output > 3L/day, Increased Urine Volume (>2ml/min) Osmotic
Causes of Polyuria ... - Differential Diagnosis ... concentration (e.g ... Recovery from Acute ... #Polyuria #Nephrology
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