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Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Nephritic vs Nephrotic ... hematuria (RBC casts ... #Syndrome #Comparison ... #Algorithm #Nephrology ... #Diagnosis
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Red blood cell casts ... Red blood cell casts ... edgarvlermamd - Nephrology ... #Comparison #Table ... #Nephrology #Diagnosis
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... #nephrology #casts
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
Algorithmic Approach ... Nephritis When ... sterile pyuria, WBC casts ... proteinuria, granular casts ... #nephrology #diagnosis
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 ... are seen in acute ... 34t5DgJ #Urinary #Casts
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
suggestive of acute ... in a variety of acute ... suggestive of nephrotic ... Urine #Microscopy #nephrology ... interpretation #diagnosis
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Algorithm Acute ... Epithelial cell casts ... Interstitial Nephritis ... #Algorithm #Causes
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Simplified Approach to Acute ... Urinary obstruction, Nephrotoxic ... PROBLEM ~80% of AKI cases ... for WBCs, RBCs, casts ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
treat underlying cause ... CHF, cirrhosis, nephrotic ... , CNS Disease, Meds ... #Algorithm #diagnosis ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... UNa > 20: • Acute ... , UNa < 20 • Nephrotic ... #Algorithm #Causes ... #nephrology