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Hematuria Workup and Diagnosis Algorithm
 • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
repeat testing • Acute ... proteinuria, RBC casts ... → Refer to Nephrology ... cystoscopy • Refer to Nephrology ... #blood #urine
Differentiation Between Nephrotic Syndrome and Nephritic Syndrome 
== Nephrotic Syndrome ==
Onset - Insidious 
Edema - ++++
Blood
cell casts - Absent ... cell casts - Present ... edgarvlermamd - Nephrology ... Nephritic #Comparison #Table ... #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 ... edgarvlermamd - Nephrology ... #Nephrology
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... suggestive of acute ... in a variety of acute ... #nephrology #interpretation ... #diagnosis
Glomerular Diseases - Nephritic and Nephrotic Syndromes

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
and Nephrotic Syndromes ... RBC casts in urine ... but in severe cases ... #Proteinuria #Nephrology ... #Diagnosis
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
Nephritic vs Nephrotic Syndrome ... hematuria (RBC casts ... dysmorphic RBCs in urine ... Comparison #Algorithm #Nephrology ... #Diagnosis
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Acute Kidney Injury ... and Differential Diagnosis ... Investigations: full blood ... osmolarity If cause ... #nephrology #causes
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
require urgent nephrology ... PROBLEM ~80% of AKI cases ... IMPROVEMENT If the urine ... for WBCs, RBCs, casts ... #nephrology
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
microscopy • Red cell casts ... • White cell casts ... infection • Hyaline casts ... disease • Granular casts ... #nephrology #casts
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
• 1ml blood/liter ... hematuria: - RBC casts ... #causes #urology ... #nephrology #renal ... #urine #blood