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diagnosis differential algorithm nephrotic hematuria microscopy nephritic proteinuria renal blood syndrome syndromes urology workup atlas classification comparison diseases interpretation key
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
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... blood cells on urine ... • Calculi Glomerular ... RBCs and/or RBC casts ... Diagnosis #Algorithm #Causes
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... suggestive of glomerulonephritis ... #Urine #Microscopy ... #nephrology #interpretation
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
Glomerular Diseases ... RBC casts in urine ... but in severe cases ... diabetes)) #Glomerular ... #Proteinuria #Nephrology
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
the patient have glomerular ... hematuria (RBC casts ... dysmorphic RBCs in urine ... Comparison #Algorithm #Nephrology
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
Membranoproliferative Glomerulonephritis ... GN • Active Urine ... dysmorphic RBC, RBC casts ... formation along glomerular ... #MPGN #nephrology
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
or dipstick) Glomerular ... of Glomerular Bleeding ... hematuria: - RBC casts ... Suggestive of glomerular ... #urology #nephrology
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
• Evidence of glomerular ... proteinuria, RBC casts ... → Refer to Nephrology ... cystoscopy • Refer to Nephrology ... if cause not identified
Algorithm - Approach to the differential diagnosis of the patient presenting with overt glomerular proteinuria. CMV
arbitrarily defined as urine ... cell/white cell casts ... because nephritic urine ... Nephrocalcinosis causes ... nephrotic #syndrome #nephrology
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... • Drugs Glomerular ... sediment - WBC/RBC casts ... #Proteinuria #Nephrology ... Diagnosis #Algorithm #Causes
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