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differential acute aki hematuria workup blood kidneyinjury management nephritis nephrotic proteinuria syndrome treatment urology acutekidneyinjury ain atlas biopsy child clinicopathology
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
Atlas of Urine Microscopy ... • Red cell casts ... • White cell casts ... disease • Granular casts ... #nephrology #casts
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... #Urine #Microscopy ... #nephrology #interpretation ... #diagnosis
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Algorithm Persistent ... sediment - WBC/RBC casts ... polyangiitis (GPA) / microscopic ... #Proteinuria #Nephrology ... #Algorithm #Causes
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
- Differential Diagnosis ... hematuria: - RBC casts ... → Diagnostic of ... #Differential #Diagnosis ... #nephrology #renal
Urine Microscopy Instructions 1) Spin fresh urine sample (10-15mL) in a centrifuge for 3-5 minutes - Don't
Urine Microscopy ... 1) Spin fresh urine ... under lower power (casts ... iMedEducation #Urine ... #nephrology #diagnosis
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup and Diagnosis ... Algorithm • Confirm ... proteinuria, RBC casts ... → Refer to Nephrology ... #Algorithm #Workup
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... Assess UA w/ microscopy ... for WBCs, RBCs, casts ... #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 ... 34t5DgJ #Urinary #Casts ... #Diagnosis #Nephrology
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 ... #nephrology #diagnosis
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
hematuria (RBC casts ... dysmorphic RBCs in urine ... Syndrome #Comparison #Algorithm ... #Nephrology #Diagnosis
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