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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
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 ... Nephritic #Comparison #Table
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
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
: - RBC casts ... and SMA - Can cause ... Bladder Causes ... Urethra/Prostate Causes ... urinary tract) Causes
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... and Diagnosis Algorithm ... proteinuria, RBC casts ... Nephrology if cause ... #Diagnosis #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
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 ... Differential #Diagnosis #Algorithm ... #Causes
Causes of Hematuria - Differential Diagnosis
Renal:
 - Glomerular - IgA Nephropathy, Thin basement membrane, Alport syndrome,
Causes of Hematuria ... - Structural - Cysts ... Anticoagulation, Facititious hematuria ... #Hematuria #Differential ... #Diagnosis #Causes
Hematuria Differential Diagnosis

- Dr. Eric Strong
@DrEricStrong

#Hematuria #Differential #Diagnosis #Table #Causes
Hematuria Differential ... DrEricStrong #Hematuria ... Differential #Diagnosis #Table ... #Causes
Urinalysis & Urine Sodium 
Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
• Urinary casts ... Injury (AKI) FE ... Necrosis (ATN) FE ... leucocyte-esterase #urine #UNa #casts ... #glucosuria #hematuria