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Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
vasculitis - Dysmorphic ... Malignant HTN • Renal ... thrombosis • Renal ... Sickle cell) • Renal ... TURP/Biopsy Renal
Urine Microscopy and Casts - Image Atlas Key

- Squamous Epithelial Casts
- Transitional Epithelial Cells
- Renal Tubular
Microscopy and Casts ... Squamous Epithelial Casts ... Epithelial Cells - Renal ... Monomorphic RBCs - Dysmorphic ... RBCs - Granular Casts
Algorithm and Differential Diagnosis of Macroscopic Hematuria
Important Historical Elements:
- Painless: suggests malignancy
- Painful: suggests calculi/infection
- Urinalysis:
Urinalysis: presence of dysmorphic ... RBC’s, RBC/WBC casts ... suggest intrinsic renal
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
cells - Normal • Renal ... urinary tract • Dysmorphic ... - Renal infection ... - Any type of renal ... More significant renal
Causes of Hyperkalemia

Hyperkalemia is caused by excess potassium intake, impaired potassium excretion, or transcellular shifts. The
Causes of Hyperkalemia ... Hyperkalemia is caused ... with impaired renal ... rarely the sole cause ... and underlying renal
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
proteinuria, RBC casts ... , dysmorphic RBCs ... Nephrology for renal ... Nephrology if cause
Causes of acute kidney injury (AKI). AKI is classified into pre-renal, renal, and post-renal causes. Renal
Causes of acute ... classified into pre-renal ... , renal, and post-renal ... causes. ... Renal causes of
Causes of Acute Kidney Injury - Differential Diagnosis Framework 
Pre-Renal
Post-Renal
Intrinsic Renal:
 • Tubules (ATN)
 • Glomerular:
Causes of Acute ... Framework Pre-Renal ... Post-Renal Intrinsic ... Renal: • Tubules ... #KidneyInjury #Causes
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
hematuria (RBC casts ... or dysmorphic RBCs
Causes of Hyperferritinemia - Differential Diagnosis
Ferritin > 1000
Ferritin is the storage form of iron. Increased hepcidin
Causes of Hyperferritinemia ... Most Common Causes ... Renal -15% 6. ... 1% Most Common Causes ... Renal failure -