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Nephritic vs Nephrotic Syndrome

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

Nephritic syndrome—due to GBM disruption. 
Hypertension. t BUN and creatinine.
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
Red blood cell casts ... Red blood cell casts ... edgarvlermamd - Nephrology ... #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 ... Microscopy #Diagnosis #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
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Acellular Casts ... • Hyaline Casts ... suggestive of nephrotic ... sydnrome • Pigment ... Urine #Microscopy #nephrology
Algorithm - Approach to the differential diagnosis of the patient presenting with overt glomerular proteinuria. CMV
hemolytic-uremic syndrome ... cell/white cell casts ... Nephrocalcinosis causes ... #proteinuria #nephrotic ... #syndrome #nephrology
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
disease - Alport syndrome ... pain hematuria syndrome ... hematuria: - RBC casts ... • Nutcracker syndrome ... #urology #nephrology
Summary of characteristic abnormalities of selected glomerular diseases
Light Microscopy (LM) - Immunofluorescence Microscopy (IM) - Electron
EM) Haematuria/nephritis ... Haemolytic-uraemic syndrome ... Nephrotic syndrome ... #diseases #nephrology ... #pathology #comparison
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN
 • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
dysmorphic RBC, RBC casts ... formation along glomerular ... anti-phospholipid syndrome ... glomerulopathy, radiation nephritis ... Glomerulonephritis #MPGN #nephrology