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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 syndromes ... hematuria (RBC casts ... #Syndrome #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 ... but in severe cases ... #Classification ... #Proteinuria #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
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 ... edgarvlermamd - Nephrology ... #Nephrology
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
• White cell casts ... • Hyaline casts ... disease • Granular casts ... crystals may indicate metabolic ... #nephrology #casts
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of nephrotic ... sydnrome • Pigment ... #nephrology #interpretation ... #diagnosis
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... GI losses • Renal ... Cirrhosis • Nephrotic ... Hypo-osmolar urine ... #Hyponatremia #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... GI losses • Renal ... Cirrhosis • Nephrotic ... Hypo-osmolar urine ... #Hyponatremia #Nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting,
Primary Metabolic ... - Differential Diagnosis ... hyperaldosteronism • High PRA: Renal ... #Algorithm #Nephrology ... #Causes
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup and Diagnosis ... proteinuria, RBC casts ... → Refer to Nephrology ... for renal biopsy ... cystoscopy • Refer to Nephrology