Most urinary casts have a fairly homogenous aspect throughout their entirety and are clearly classifiable as either hyaline, granular (with all their variants), waxy, or of some cellular nature. However, in many instances urinary casts are not homogenous…
Crystals are a frequent finding in the urinary sediment. Besides microcrystalline deposits (amorphous phosphates and urates), the most common types of crystals in my practice are: 1. CaOxalate dihydrate (COD) 2. CaOxalate monohydrate (COM) 3. Uric acid …
BK virus (BKV) is a DNA virus that infects up to 90% of the adult population. After initial exposure in childhood, the virus becomes latent in urothelial tissues. In transplant patients, BKV can reactivate in the context of…
White blood cells (WBC’s) in the urine may occur as a result of infection or inflammation anywhere in the urinary tract and the segmented polymorphonuclear neutrophil is the type most often encountered. These WBC’s are identified by the…
Perhaps that most highly sought finding in urinary sediment microscopy is the presence of granular casts. In clinical grounds, granular casts are typically associated with acute tubular injury (ATI) and guide the differentiation between prerenal and overt tubular…
The use of urine sediment analysis is important for the diagnosis of glomerular hematuria. Red blood cells (RBC) casts, beautifully illustrated by @jrseltzer in last month’s post, usually confirm glomerular hematuria – but this is a rather special…
Red Blood Cell (RBC) Casts:RBC casts (Fig. 1) are an important finding in the urinary sediment and most often signify the presence of a proliferative glomerulonephritis or vasculitic process. Although less common, RBC casts may also be seen…
Waxy casts are found during microscopic examination of the urinary sediment. Like other casts, they are cylindrical structures, but they are distinctly characterized by a high refractive index. Their shape can be straight (Fig. 1A, top cast), convoluted (Fig….
Below, take a look at nearly round “oval fat bodies” in the urine of a patient with the nephrotic syndrome. Their presence is a sign of higher grade proteinuria: The so called “oval fat bodies” are a common finding in…
We are excited to introduce a new series, “Urine Sediment of the Month“, and looking forward to contributions from Dr. Jay Seltzer, Dr. Juan Carlos Velez, and Dr. Florian Buchkremer. Here’s the inaugural post, courtesy of Dr. Seltzer:…
