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algorithm urine differential aki blood hematuria kidneyinjury urology workup atlas classification comparison diseases diuresis diuretics excretion glomerulonephritis interpretation interstitial key
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
Nephritic vs Nephrotic ... the patient have glomerular ... casts or dysmorphic ... Comparison #Algorithm #Nephrology ... #Diagnosis
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
RBC casts in urine ... severe cases ... may be in nephrotic ... #Proteinuria #Nephrology ... #Diagnosis
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
Interstitial Nephritis ... casts, eosinophiluria ... proteinuria, granular casts ... #Interstitial #Nephritis ... #nephrology #diagnosis
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
• Red cell casts ... • White cell casts ... • Hyaline casts ... disease • Granular casts ... #nephrology #casts
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
suggestive of nephrotic ... • RBC Casts - ... glomerulonephritis • WBC ... #nephrology #interpretation ... #diagnosis
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... are seen in acute ... tubulointerstitial nephritis ... Fatty - Nephrotic ... #Diagnosis #Nephrology
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
- Differential Diagnosis ... syndrome: • Flank pain ... casts → Diagnostic ... #Differential #Diagnosis ... #nephrology #renal
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Epithelial cell casts ... polyangiitis /microscopic ... Interstitial Nephritis ... #KidneyInjury #Nephrology
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
repeat testing • Acute ... unilateral flank pain ... • Evidence of glomerular ... casts, dysmorphic ... for renal biopsy
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
Urinary obstruction, Nephrotoxic ... PROBLEM ~80% of AKI cases ... Assess UA w/ microscopy ... for WBCs, RBCs, ... casts, crystals
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