20 results
Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
Glomerular Diseases ... RBC casts in urine ... but in severe cases ... #Proteinuria #Nephrology ... #Diagnosis
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
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
the patient have glomerular ... hematuria (RBC casts ... dysmorphic RBCs in urine ... Comparison #Algorithm #Nephrology ... #Diagnosis
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
- Differential Diagnosis ... pain hematuria syndrome ... hematuria: - RBC casts ... → Diagnostic of ... #nephrology #renal
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup and Diagnosis ... repeat testing • Acute ... • Evidence of glomerular ... proteinuria, RBC casts ... → Refer to Nephrology
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of acute ... in a variety of acute ... #nephrology #interpretation ... #diagnosis
Causes of Proteinuria - Differential Diagnosis Algorithm
Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential Diagnosis ... • Fanconi's syndrome ... • Drugs Glomerular ... sediment - WBC/RBC casts ... #Proteinuria #Nephrology
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
- TTP/HUS • Glomerular ... tubular necrosis (causes ... : sepsis, meds, ... Classification #diagnosis ... #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 ... are seen in acute ... 34t5DgJ #Urinary #Casts
Algorithm - Approach to the differential diagnosis of the patient presenting with overt glomerular proteinuria. CMV
hemolytic-uremic syndrome ... arbitrarily defined as urine ... cell/white cell casts ... #nephrotic #syndrome ... #nephrology