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nephrology differential acute aki hematuria alkalosis hypokalemia metabolic urology workup blood clinical instructions kidneyinjury management nephritis nephrotic proteinuria renal syndrome
Granular & “Muddy Brown” Casts on Urine Microscopy A. Finely granular cast B. slightly coarser granular cast
“Muddy Brown” Casts ... on Urine Microscopy ... of mb granular casts ... appreciated at low ... #Urine #Microscopy
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
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... #Urine #Microscopy ... #nephrology #interpretation ... #diagnosis
Causes of Proteinuria - Differential Diagnosis Algorithm Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
- Differential Diagnosis ... Algorithm Persistent ... sediment - WBC/RBC casts ... polyangiitis (GPA) / microscopic ... #Algorithm #Causes
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Hematuria Workup and Diagnosis ... Algorithm • Confirm ... proteinuria, RBC casts ... if cause not identified ... #Algorithm #Workup
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 ... #causes #urology
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
: Hypovolemia, Low ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... Assess UA w/ microscopy ... for WBCs, RBCs, casts
Urine Microscopy Instructions 1) Spin fresh urine sample (10-15mL) in a centrifuge for 3-5 minutes - Don't
Urine Microscopy ... 1) Spin fresh urine ... under lower power (casts ... iMedEducation #Urine ... #nephrology #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
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
Algorithmic Approach ... sterile pyuria, WBC casts ... eosinophiluria, microscopic ... proteinuria, granular casts ... #nephrology #diagnosis
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