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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 ... Syndrome #Comparison #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
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
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Proteinuria - ++++ Hematuria ... Red blood cell casts ... Proteinuria - ++ Hematuria ... Red blood cell casts
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
pattern includes abnormalities ... Emphysema - Lung cysts ... Diagnosis #Radiology #Pulmonary ... TractionBronchiectasis #Cysts
Causes of Hematuria - Differential Diagnosis
Renal:
 - Glomerular - IgA Nephropathy, Thin basement membrane, Alport syndrome,
Causes of Hematuria ... - Structural - Cysts ... Uncertain - Exercise haematuria ... Anticoagulation, Facititious hematuria ... #Hematuria #Differential
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... and Diagnosis Algorithm ... • Confirm hematuria ... proteinuria, RBC casts ... #Diagnosis #Algorithm
Causes of Hematuria - Differential Diagnosis Algorithm
Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... Differential Diagnosis Algorithm ... RBCs and/or RBC casts ... ) - Isolated Hematuria ... Differential #Diagnosis #Algorithm
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
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
Hematuria - Differential ... Framework Gross Hematuria ... change • Gross hematuria ... tract source • Hematuria ... : - RBC casts