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algorithm urine injury kidney management workup cardiology endocarditis kidneyinjury renal treatment urology acutekidneyinjury ain atlas bloodsmear borrelia clinical clinicopathology crystals
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
sensitive) • AKI ... sterile pyuria, WBC casts ... hematuria, mild ... proteinuria, granular casts ... #diagnosis
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
Hematuria - Differential ... urine • 1ml blood ... : - RBC casts ... Diagnosis #causes ... #urology #nephrology
Causes of Dysuria - Differential Diagnosis Algorithm Pyuria - Leukocytes on Dipstick/Microscopy - Bacteriuria & Hematuria -
Causes of Dysuria ... - Differential ... Diagnosis Algorithm ... Pyelonephritis - WBC Casts ... #Causes
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... (AKI) - Acute increase ... Epithelial cell casts ... polyangiitis /microscopic ... #Nephrology #Differential
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
• Red cell casts ... glomerular disease • Leukocytes ... • White cell casts ... disease • Granular casts ... #nephrology #casts
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
Simplified Approach to Acute ... cases are caused ... Assess UA w/ microscopy ... for WBCs, RBCs, casts ... #nephrology
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... - Differential ... Diagnosis Algorithm ... Red blood cells ... RBCs and/or RBC casts
Acute Kidney Injury - Differential Diagnosis Framework PRERENAL: - Intrarenal vasoconstriction-hemodynamically mediated - Systemic vasodilation - Volume
cell casts on UA ... renal tubular cell casts ... or pigmented casts ... treating underlying cause ... Kidney #Injury #AKI
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
and Diagnosis Algorithm ... repeat testing • Acute ... proteinuria, RBC casts ... → Refer to Nephrology ... Workup #urology #blood
Urinalysis & Urine Sodium Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
Microscopic exam ... • Urinary casts ... (AKI) FE Na < ... #urine #UNa #casts ... #glucosuria #hematuria
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