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Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... but in severe cases ... #Nephrotic #Syndromes
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Syndrome Step ... /nephritic syndromes ... hematuria (RBC casts ... dysmorphic RBCs in urine ... #Syndrome #Comparison
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Syndrome and Nephritic ... Syndrome == Nephrotic ... Red blood cell casts ... Red blood cell casts ... #Syndrome #Nephritic
Classification, Differential Diagnosis, and Features of Hyponatremia According to Volume Status 

Hypervolemic hypernatremia 
 - CHF
and Features of Hyponatremia ... Hypervolemic hypernatremia ... Cirrhosis - Nephrotic ... syndrome - Acute ... Diagnosis #Table #Causes
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
microscopy • Red cell casts ... glomerular disease • Leukocytes ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... suggestive of nephrotic ... sydnrome • Pigment ... #Urine #Microscopy
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Cirrhosis • Nephrotic ... syndrome • Reduced ... Hypo-osmolar urine
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Diagnosis Algorithm Syndrome ... Cirrhosis • Nephrotic ... syndrome • Reduced ... Hypo-osmolar urine
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... and concentrated urine ... breakdown of cellular casts ... heme-granular casts ... 34t5DgJ #Urinary #Casts
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid >4 • Urine ... failure, Cirrhosis, Nephrotic ... syndromeUrine ... SatyaPatelMD #Volume #Hyponatremia