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diagnosis differential acute aki alkalosis hypokalemia metabolic microscopy syndrome workup hyperkalemia hyponatremia intercellularshift kidneyinjury nephritis nephrotic proteinuria sodium acutekidneyinjury ain
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
• White cell casts ... infection • Hyaline casts ... disease • Granular casts ... key #diagnosis #nephrology ... #casts
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
“Muddy Brown” Casts ... of mb granular casts ... appreciated at low ... Granular #MuddyBrown #Casts ... #Clinical #Nephrology
Polyuria - Differential Diagnosis Algorithm Polyuria = >3L Urine output / 24 hours Urine osmolality = 2 (Na
Diagnosis Algorithm ... Polyuria = >3L ... nutrition), Azotemia LOW ... Differential #Diagnosis #Algorithm ... #nephrology
Causes of Polyuria - Differential Diagnosis Algorithm Polyuria - Urine Output > 3L/day, Increased Urine Volume (>2ml/min) Osmotic
Causes of Polyuria ... Polyuria - Urine ... • Increased urea ... #Nephrology #Differential ... #Causes
Polyuria - Differential Diagnosis Algorithm Urine Output > 3L /day Water Diuresis (Urine Osm <100 mOsm/kg) • Primary
Polyuria - Differential ... Diagnosis Algorithm ... solute load #Polyuria ... Differential #Diagnosis #Algorithm ... #causes #nephrology
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
require urgent nephrology ... : Hypovolemia, Low ... PROBLEM ~80% of AKI cases ... for WBCs, RBCs, casts ... workup #diagnosis #nephrology
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
and Diagnosis Algorithm ... proteinuria, RBC casts ... → Refer to Nephrology ... cystoscopy • Refer to Nephrology ... if cause not identified
Causes of Hypernatremia - Differential Diagnosis Algorithm Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L High
Causes of Hypernatremia ... diuresis (see Polyuria ... mannitol, glucosuria Low ... Hypernatremia #Nephrology ... #Causes
Causes of Polyuria - Differential Diagnosis Excess Intake of Water: • Primary polydipsia (a.k.a. "psychogenic polydipsia") •
Causes of Polyuria ... • Central Dl (Low ... Mimics (↑ urine ... frequency without ↑ urine ... #nephrology
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Epithelial cell casts ... crystals • Calcium ... #KidneyInjury #Nephrology ... #Causes
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