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differential algorithm management syndrome aki microscopy nephrotic proteinuria barre blood guillain hematuria injury kidney nephritic renal urology workup atlas cancer
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
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
repeat testing • Acute ... • Evidence of glomerular ... proteinuria, RBC casts ... → Refer to Nephrology ... cystoscopy • Refer to Nephrology
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 ... Nephrotic #Syndromes #Classification ... #Proteinuria #Nephrology ... #Diagnosis
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
the patient have glomerular ... hematuria (RBC casts ... dysmorphic RBCs in urine ... #Algorithm #Nephrology ... #Diagnosis
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of acute ... in a variety of acute ... #nephrology #interpretation ... #diagnosis
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
- Differential Diagnosis ... hematuria: - RBC casts ... → Diagnostic of ... #causes #urology ... #nephrology #renal
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential Diagnosis ... • Drugs Glomerular ... sediment - WBC/RBC casts ... #Proteinuria #Nephrology ... #Algorithm #Causes
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
require urgent nephrology ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... for WBCs, RBCs, casts ... #nephrology
Acute Kidney Injury - Classification Prerenal: • Dehydration • Heart failure (a.k.a. cardiorenal syndrome) • Liver failure
- Classification ... - TTP/HUS • Glomerular ... tubular necrosis (causes ... Kidney #Injury #Classification ... #diagnosis #nephrology
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
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