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Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
hematuria (RBC casts ... dysmorphic RBCs in ... urine)? ... Syndrome #Comparison #Algorithm ... #Nephrology #Diagnosis
Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
RBC casts in urine ... severe cases ... may be in nephrotic ... #Proteinuria #Nephrology ... #Diagnosis
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... GI losses • Renal ... Cirrhosis • Nephrotic ... Hypo-osmolar urine ... #Diagnosis #Algorithm
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... GI losses • Renal ... Cirrhosis • Nephrotic ... Hypo-osmolar urine ... #Diagnosis #Algorithm
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... failure, Cirrhosis, Nephrotic ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... • Hyaline casts ... disease • Granular casts ... #nephrology #casts
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... and concentrated urine ... breakdown of cellular casts ... heme-granular casts ... 34t5DgJ #Urinary #Casts
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... liver failure, nephrotic ... #Algorithm #causes ... #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... - Differential Diagnosis ... , UNa < 20 • Nephrotic ... #Algorithm #Causes ... #nephrology
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of nephrotic ... #Urine #Microscopy ... #nephrology #interpretation ... #diagnosis