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diagnosis differential algorithm management nephrotic microscopy nephritic renal syndrome urology blood comparison endocarditis glomerular glomerulonephritis nephritis syndromes workup abnormal ain
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
repeat testing • Acute ... glomerular bleeding (proteinuria ... , RBC casts, dysmorphic ... → Refer to Nephrology ... if cause not identified
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
the patient has hematuria ... and/or proteinuria ... (RBC casts or dysmorphic ... RBCs in urine)? ... Comparison #Algorithm #Nephrology
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
hematuria. ... RBC casts in urine ... Proteinuria often ... but in severe cases ... #Nephrology #Diagnosis
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
: Red/Dark urine ... 1ml blood/liter urine ... : - RBC casts ... - Proteinuria ... #urology #nephrology
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome == Nephrotic Syndrome == Onset - Insidious Edema - ++++ Blood
- Normal/low Proteinuria ... - ++++ Hematuria ... Red blood cell casts ... - ++ Hematuria ... Red blood cell casts
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... (Negative urine ... sediment - WBC/RBC casts ... #Nephrology #Differential ... Diagnosis #Algorithm #Causes
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
sterile pyuria, WBC casts ... eosinophiluria, microscopic hematuria ... , mild tubular proteinuria ... , granular casts ... AIN #Algorithm #nephrology
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 ... #Urine #Microscopy ... #nephrology #interpretation
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... blood cells on urine ... RBCs and/or RBC casts ... nephrotic range) proteinuria ... Diagnosis #Algorithm #Causes
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
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