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diagnosis differential algorithm management renal syndrome clinical glomerular kidney nephrotic acute glomerulonephritis physicalexam video aki nephritic ophthalmology treatment urine urology
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup ... glomerular bleeding (proteinuria ... → Refer to Nephrology ... cystoscopy • Refer to Nephrology ... if cause not identified
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome == Nephrotic Syndrome == Onset - Insidious Edema - ++++ Blood
- Normal/low Proteinuria ... - ++++ Hematuria ... - ++ Hematuria ... edgarvlermamd - Nephrology ... Comparison #Table #Nephrology
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
syndrome—due to GBM ... hematuria. ... RBC casts in urine ... Proteinuria often ... #Nephrology #Diagnosis
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
the patient has hematuria ... and/or proteinuria ... have glomerular hematuria ... (RBC casts or dysmorphic ... Comparison #Algorithm #Nephrology
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
Brown urine - Proteinuria ... Mass Ureteral Causes ... Urethra/Prostate Causes ... Differential #Diagnosis #causes ... #urology #nephrology
Glomerular Diseases - Spectrum - Insidious vs Acute - Nephritic (hypertension, hematuria, renal failure) vs Nephrotic
(hypertension, hematuria ... Nephrotic (Heavy proteinuria ... differential #diagnosis #nephrology
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... sediment - WBC/RBC casts ... proliferative • Anti-GBM ... #Nephrology #Differential ... Diagnosis #Algorithm #Causes
Algorithm and Differential Diagnosis of Macroscopic Hematuria Important Historical Elements: - Painless: suggests malignancy - Painful: suggests calculi/infection - Urinalysis:
of Macroscopic Hematuria ... RBC’s, RBC/WBC casts ... , proteinuria suggest ... prostatic) #Diagnosis #EM ... #IM #Urology #Hematuria
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
sterile pyuria, WBC casts ... eosinophiluria, microscopic hematuria ... , mild tubular proteinuria ... , granular casts ... AIN #Algorithm #nephrology
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... nephropathy • Thin GBM ... ) • Anti-GBM ... nephrotic range) proteinuria ... Diagnosis #Algorithm #Causes
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