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Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Nephritic vs Nephrotic ... /nephritic syndromes ... hematuria (RBC casts ... #Nephritic #Nephrotic ... Syndrome #Comparison #Algorithm
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Syndrome and Nephritic ... Syndrome == Nephrotic ... Red blood cell casts ... Red blood cell casts ... #Comparison #Table
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... Casts • Hyaline ... Casts - Consists ... suggestive of nephrotic
Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... but in severe cases ... may be in nephrotic
Urine Microscopy and Casts - Image Atlas Key

- Squamous Epithelial Casts
- Transitional Epithelial Cells
- Renal Tubular
Urine Microscopy ... and Casts - Image ... Squamous Epithelial Casts ... RBCs - Granular Casts ... #Casts #Atlas #
Causes of Hematuria - Differential Diagnosis Algorithm
Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... cells on urine microscopy ... • Neoplasm/Cyst ... RBCs and/or RBC casts ... #Causes
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
Algorithmic Approach ... sterile pyuria, WBC casts ... eosinophiluria, microscopic ... proteinuria, granular casts ... #AIN #Algorithm
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 ... 34t5DgJ #Urinary #Casts ... #Differential #Microscopy
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
• Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... diagnosis #nephrology #casts
Mixed Cellular Casts on Urine Microscopy

Degenerating mixed cellular cast - brightfield, unstained - from patient with
Mixed Cellular Casts ... on Urine Microscopy ... mixed cellular cast ... #Cellular #Casts ... clinical #Urine #Microscopy