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differential algorithm aki hematuria nephrotic proteinuria renal syndrome workup blood kidneyinjury nephritic syndromes urology acutekidneyinjury ain atlas classification comparison diseases
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
Atlas of Urine Microscopy ... • Red cell casts ... • White cell casts ... disease • Granular casts ... #nephrology #casts
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
- Differential Diagnosis ... hematuria: - RBC casts ... → Diagnostic of ... #Differential #Diagnosis ... #nephrology #renal
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of acute ... #Urine #Microscopy ... #nephrology #interpretation ... #diagnosis
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup and Diagnosis ... repeat testing • Acute ... • Evidence of glomerular ... proteinuria, RBC casts ... → Refer to Nephrology
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential Diagnosis ... • Drugs Glomerular ... sediment - WBC/RBC casts ... polyangiitis (GPA) / microscopic ... #Proteinuria #Nephrology
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 ... #Proteinuria #Nephrology ... #Diagnosis
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
Simplified Approach to Acute ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... Assess UA w/ microscopy ... for WBCs, RBCs, casts
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 ... #Diagnosis
Causes of Hematuria - Differential Diagnosis Algorithm Red blood cells on urine microscopy. Must exclude false positives
- Differential Diagnosis ... blood cells on urine ... microscopy. ... RBCs and/or RBC casts ... #Differential #Diagnosis
Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... breakdown of cellular casts ... heme-granular casts ... 34t5DgJ #Urinary #Casts ... #Diagnosis #Nephrology
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