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diagnosis nephrology differential management urine addiction acute aki buprenorphine clinical checklist comparison hematuria initiation kidneyinjury methadone nephritis nephrotic opioid physicalexam
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
• Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... diagnosis #nephrology #casts
Mixed Cellular Casts on Urine Microscopy Degenerating mixed cellular cast - brightfield, unstained - from patient with
Mixed Cellular Casts ... on Urine Microscopy ... unstained - from patient ... #Cellular #Casts ... clinical #Urine #Microscopy
Crystal cast in patient with AKI and TLS on Urine Microscopy Randy Luciano MD, PhD @RandyLucianoMD #TLS #Crystal
Crystal cast in ... patient with AKI ... and TLS on Urine Microscopy ... #casts #crystalluria ... #Urine #Microscopy
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
PHYSICAL Assess if patient ... PROBLEM ~80% of AKI cases ... Assess UA w/ microscopy ... for WBCs, RBCs, casts ... , crystals, protein
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm Acute Kidney Injury (AKI) - Acute increase
Differential Diagnosis Algorithm ... Epithelial cell casts ... Obstruction • Cast ... myeloma) • Urate crystals ... polyangiitis /microscopic
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
Algorithmic Approach ... sterile pyuria, WBC casts ... eosinophiluria, microscopic ... proteinuria, granular casts ... Nephritis #AIN #Algorithm
Urine Microscopy - Urinary Sediment Examination Instructions Preparation of the urine for microscopic examination: • Clean catch
up by cells or casts ... Ill stain) and crystals ... RBC's, lipids, crystals ... protein matrix of casts ... identification of lipids, crystals
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Differential Diagnosis Algorithm ... cells on urine microscopy ... RBCs and/or RBC casts ... with polyangiitis/microscopic ... #Causes
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Differential Diagnosis Algorithm ... sediment - WBC/RBC casts ... polyangiitis (GPA) / microscopic ... Differential #Diagnosis #Algorithm ... #Causes
Causes of Dysuria - Differential Diagnosis Algorithm Pyuria - Leukocytes on Dipstick/Microscopy - Bacteriuria & Hematuria -
Differential Diagnosis Algorithm ... Leukocytes on Dipstick/Microscopy ... Pyelonephritis - WBC Casts ... Leukocytes on Dipstick/Microscopy ... #Causes
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