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diagnosis differential algorithm workup management nephrotic rheumatology syndrome urology aki blood cardiology classification endocarditis glomerular infectiousdiseases nephritic proteinuria renal syndromes
Hematuria - Differential Diagnosis Framework Gross Hematuria: Red/Dark urine • 1ml blood/liter urine can induce color change
Microscopic ... : • Flank pain ... : - RBC casts ... • Urethritis ... #urology #nephrology
Urine Microscopy - Casts Acellular Casts • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of acute ... • RBC Casts - ... #Urine #Microscopy ... #nephrology #interpretation
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
repeat testing • Acute ... unilateral flank pain ... WBCs, or urine ... casts, dysmorphic ... if cause not identified
Algorithmic Approach to Acute Interstitial Nephritis When to suspect AIN? (not sensitive) • AKI, AKD, rapidly progressive
sterile pyuria, WBC ... casts, eosinophiluria ... , microscopic hematuria ... proteinuria, granular casts ... #Algorithm #nephrology
Nephritic vs Nephrotic Syndrome Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes. Step
the patient has hematuria ... have glomerular hematuria ... (RBC casts or dysmorphic ... RBCs in urine)? ... Comparison #Algorithm #Nephrology
Simplified Approach to Acute Kidney Injury (AKI) 1) IS THIS AN EMERGENCY? Is there a dialysis indication
PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... Assess UA w/ microscopy ... for WBCs, RBCs, ... casts, crystals
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
Atlas of Urine Microscopy ... • Red cell casts ... • White cell casts ... key #diagnosis #nephrology ... #casts
Glomerular Diseases - Nephritic and Nephrotic Syndromes Nephritic syndrome—due to GBM disruption. Hypertension. t BUN and creatinine.
hematuria. ... RBC casts in urine ... 3.5 g/day) but in ... severe cases ... #Proteinuria #Nephrology
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 ... are seen in acute ... 34t5DgJ #Urinary #Casts
Urinalysis & Urine Sodium Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
Microscopic exam ... Red blood cells (RBC ... • Urinary casts ... #UNa #casts #glucosuria ... #hematuria
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