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Glomerular Diseases - Nephritic and Nephrotic Syndromes

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

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Syndrome Step ... hematuria and/or proteinuria ... /nephritic syndromes ... hematuria (RBC casts ... #Algorithm #Nephrology
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
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
sensitive) • AKI ... sterile pyuria, WBC casts ... , mild tubular proteinuria ... , granular casts ... AIN #Algorithm #nephrology
Acute Kidney Injury - Classification
Prerenal:
 • Dehydration
 • Heart failure (a.k.a. cardiorenal syndrome)
 • Liver failure
Acute Kidney Injury ... - Classification ... tubular necrosis (causes ... Acute interstitial nephritis ... #diagnosis #nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Kidney Injury (AKI ... • Hepatorenal syndromes ... Epithelial cell casts ... Acute Interstitial Nephritis ... #KidneyInjury #Nephrology
Lupus Nephritis - Diagnostic approach to kidney disease associated with systemic lupus erythematosus (SLE)
SLE patient develops
develops new: • Proteinuria ... dysmorphic RBCs, RBC casts ... , WBC casts) especially ... with evidence of proteinuria ... algorithm #sle #nephrology
Albuminuria (Grades) and Risk for CKD
Normal to mildly increased albuminuria:
 - Albumin excretion rate: < 30
of progressive kidney ... Nephrotic-range ... syndrome ... Albuminuria #Grades #classification ... #CKD #nephrology
Acute Kidney Injury - Differential Diagnosis Framework
PRERENAL:
 - Intrarenal vasoconstriction-hemodynamically mediated
 - Systemic vasodilation
 - Volume
red blood cells/proteinuria ... white blood cell casts ... renal tubular cell casts ... or pigmented casts ... treating underlying cause
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 ... syndrome ("Maltese ... 34t5DgJ #Urinary #Casts