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diagnosis differential nephrology algorithm hematuria urine urology blood renal acute aki atlas chronic ckd em interpretation key kidneydisease kidneyinjury macroscopic
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
• Red cell casts ... • White cell casts ... infection • Hyaline casts ... • Granular casts ... #casts
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... • Evidence of glomerular ... proteinuria, RBC casts ... if cause not identified ... by UW IM Residency
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
basement membrane disease ... hematuria: - RBC casts ... disease Renal ... microscopic and ... #urology #nephrology
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... acute and chronic kidney ... diseases • Fatty ... #Urine #Microscopy ... #nephrology #interpretation
Causes of Chronic Kidney Disease - Differential Diagnosis Algorithm Decreased kidney function (eGFR < 60 ml/min/1.73 m2)
Causes of Chronic ... Kidney Disease ... Atherosclerosis Glomerular ... Sterile pyuria, WBC casts ... KidneyDisease #Nephrology
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
Approach to Acute Kidney ... PROBLEM ~80% of AKI cases ... Assess UA w/ microscopy ... for WBCs, RBCs, casts ... KidneyInjury #simplified #workup
Algorithm and Differential Diagnosis of Macroscopic Hematuria Important Historical Elements: - Painless: suggests malignancy - Painful: suggests calculi/infection - Urinalysis:
RBC’s, RBC/WBC casts ... intrinsic renal disease ... Diagnosis #EM #IM ... #Urology #Hematuria ... Differential #Algorithm #Ddxof
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 ... broad - Advanced kidney ... 34t5DgJ #Urinary #Casts
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... • Drugs Glomerular ... sediment - WBC/RBC casts ... polyangiitis (GPA) / microscopic ... Minimal change disease
Causes of Hematuria - Differential Diagnosis Renal: - Glomerular - IgA Nephropathy, Thin basement membrane, Alport syndrome,
Causes of Hematuria ... Diagnosis Renal: - Glomerular ... Medullary sponge kidney ... necrosis, Sickle cell disease ... #urology
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