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Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
the patient has hematuria ... (RBC casts or dysmorphic ... RBCs in urine)? ... Nephrotic #Syndrome #Comparison ... #Algorithm #Nephrology
Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
and Diagnosis Algorithm ... repeat testing • Acute ... proteinuria, RBC casts ... → Refer to Nephrology ... #Diagnosis #Algorithm
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 ... and chronic kidney ... #nephrology #interpretation
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
Algorithmic Approach ... sterile pyuria, WBC casts ... eosinophiluria, microscopic hematuria ... proteinuria, granular casts ... #nephrology #diagnosis
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Proteinuria - ++++ Hematuria ... Red blood cell casts ... Red blood cell casts ... Syndrome #Nephritic #Comparison ... #Table #Nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Kidney Injury (AKI ... Acute Kidney Injury ... Epithelial cell casts ... #KidneyInjury #Nephrology
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Simplified Approach to Acute ... Kidney Injury ( ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... for WBCs, RBCs, casts
Causes of Polyuria - Differential Diagnosis Algorithm
Polyuria - Urine Output > 3L/day, Increased Urine Volume (>2ml/min)
Osmotic
Causes of Polyuria ... Differential Diagnosis Algorithm ... Recovery from Acute ... #Polyuria #Nephrology ... #Causes
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 ... are seen in acute ... 34t5DgJ #Urinary #Casts
Urinalysis & Urine Sodium 
Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
proteinuria as a disease state ... • Urinary casts ... Acute Kidney Injury ... #UNa #casts #glucosuria ... #hematuria