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Nephritic vs Nephrotic Syndrome

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

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... #Proteinuria #Nephrology ... #Diagnosis
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Syndrome and Nephritic ... Syndrome == Nephrotic ... pressure - Normal/low ... #Syndrome #Nephritic ... #Diagnosis
Algorithm for Differentiating Gitelman syndrome from Bartter syndrome
 • Urine Chloride
 • Urine Ca/Cr ratio

Dr. Krithika
Gitelman syndrome ... • Urine Chloride ... • Urine Ca/Cr ... #Algorithm #nephrology ... #hypokalemia #diagnosis
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting, NGT
- Differential Diagnosis ... Algorithm Volume ... Urine Cl-: Vomiting ... , Gitelman Syndrome ... #Algorithm #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting,
- Differential Diagnosis ... Algorithm Volume ... Urine Cl-: Vomiting ... , Gitelman Syndrome ... #Algorithm #Nephrology
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
and concentrated urine ... are seen in acute ... syndrome ("Maltese ... Differential #Microscopy #Diagnosis ... #Nephrology
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of nephrotic ... sydnrome • Pigment ... #nephrology #interpretation ... #diagnosis
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
- Differential Diagnosis ... Algorithm Extra-renal ... , Gitelman syndrom ... #Algorithm #causes ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
failure, Cirrhosis, Nephrotic ... syndromeUrine ... #Hyponatremia #algorithm ... #diagnosis #sodium ... #low #nephrology