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Nephritic vs Nephrotic Syndrome

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

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
Glomerular Diseases ... hematuria. ... RBC casts in urine ... but in severe cases ... #Proteinuria #Nephrology
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
disease - Alport syndrome ... syndrome: • ... RBC casts → Diagnostic ... • Nutcracker syndrome ... #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
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Proteinuria - ++++ Hematuria ... Red blood cell casts ... Red blood cell casts ... #Nephritic #Comparison ... #Table #Nephrology
Causes of Proteinuria - Differential Diagnosis Algorithm
Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... • Fanconi's syndrome ... • Drugs Glomerular ... sediment - WBC/RBC casts ... #Proteinuria #Nephrology
Algorithm - Approach to the differential diagnosis of the patient presenting with overt glomerular proteinuria. CMV
hemolytic-uremic syndrome ... cell/white cell casts ... Nephrocalcinosis causes ... Hematuria may be ... #nephrology
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN
 • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
GN • Active Urine ... dysmorphic RBC, RBC casts ... formation along glomerular ... anti-phospholipid syndrome ... Glomerulonephritis #MPGN #nephrology
Pulmonary Renal Syndromes - OnePager Summary
Autoimmune ANCA vasculitis (AAV): GPA (granulomatous with polyangiitis), EGPA (eosinophilic granulomatosis
, proteinuria, hematuria ... : UA, Urine protein ... Goodpasture's cause ... , RBC casts, low ... hypercellular glomeruli