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Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Syndrome Step ... /nephritic syndromes ... hematuria (RBC casts ... dysmorphic RBCs in urine ... #Algorithm #Nephrology
Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... Nephritic syndrome—due ... RBC casts in urine ... but in severe cases ... #Proteinuria #Nephrology
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
Syndrome and Nephritic ... Syndrome == Nephrotic ... Red blood cell casts ... Red blood cell casts ... #Syndrome #Nephritic
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... and concentrated urine ... breakdown of cellular casts ... heme-granular casts ... 34t5DgJ #Urinary #Casts
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of nephrotic ... sydnrome • Pigment ... #Urine #Microscopy ... #nephrology #interpretation
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal ... Hypo-osmolar urine ... #Hyponatremia #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Cirrhosis • Nephrotic ... GFR, AKI/CRF Hormonal ... Hypo-osmolar urine ... #Hyponatremia #Nephrology
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
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
require urgent nephrology ... Urinary obstruction, Nephrotoxic ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... for WBCs, RBCs, casts
Causes of Proteinuria - Differential Diagnosis Algorithm
Persistent Proteinuria >150mg/d protein present on repeat testing including overnight
Causes of Proteinuria ... • Fanconi's syndrome ... sediment - WBC/RBC casts ... #Proteinuria #Nephrology ... Diagnosis #Algorithm #Causes