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diagnosis differential nephrology causes management cardiology aki casts urology chronic hepatology microscopy nephrotic proteinuria syndrome workup blood chf criticalcare cystic
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... and Diagnosis Algorithm ... repeat testing • Acute ... proteinuria, RBC casts ... #Diagnosis #Algorithm
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
Algorithmic Approach ... sterile pyuria, WBC casts ... eosinophiluria, microscopic hematuria ... proteinuria, granular casts ... Nephritis #AIN #Algorithm
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
the patient has hematuria ... have glomerular hematuria ... (RBC casts or dysmorphic ... RBCs in urine)? ... Syndrome #Comparison #Algorithm
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... suggestive of acute ... in a variety of acute ... #Urine #Microscopy
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 ... diagnosis #nephrology #casts
Algorithm and Differential Diagnosis of Macroscopic Hematuria Important Historical Elements: - Painless: suggests malignancy - Painful: suggests calculi/infection - Urinalysis:
Algorithm and Differential ... of Macroscopic Hematuria ... RBC’s, RBC/WBC casts ... #IM #Urology #Hematuria ... #Differential #Algorithm
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... Differential Diagnosis Algorithm ... blood cells on urine ... RBCs and/or RBC casts ... Differential #Diagnosis #Algorithm
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
: Red/Dark urine ... 1ml blood/liter urine ... more RBC/HPF spun urine ... examination of urine ... : - RBC casts
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
hematuria. ... RBC casts in urine ... but in severe cases
Urinalysis & Urine Sodium Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
• Urinary casts ... Acute Kidney Injury ... Acute Tubular Necrosis ... #UNa #casts #glucosuria ... #hematuria
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