Casts form in the distal tubules and collecting ducts when either Tamm-Horsfall mucoprotein or fibrin agglutinate and become molded into cylindrical structures within the tubular lumen. Cells and various substances, when present in the tubule, are incorporated into…
A 56-year-old kidney transplant recipient due to IgA nephropathy presented to the emergency department with a two day history of fatigue, gross hematuria, and pain over her allograft. She was diagnosed with transplant pyelonephritis and treated with antibiotics…
Routine work with urine microscopy can lead to plenty of “surprises.” Sometimes not only the microscopic evaluation presents something new and unique, but the findings can be observed directly by looking at the sample. The original post on…
Red blood cells (RBCs) in the urine are normally 7-8 µm in diameter, circular or slightly oval and biconcave in appearance. They may appear crenated, with symmetric spiked membrane contour in hypertonic urine, or spherical, with near loss…
The influence of urine concentration on the cells we observe during urine microscopy is well known. Concentrated urine specimens with a high urine specific gravity (SG) preserve nucleated cellular morphology the best, however, some cellular structures (e.g.: erythrocytes)…
The thickness of the fluid layer examined by urinary microscopy is determined by the volume of resuspended sediment put on the glass slide and the size of the coverslip. Using 13-15ul of sediment and coverslips of 18x18mm2 as…
A 50 y/o woman presents with symptoms of fatigue and malaise for 1-2 weeks. Medications include ACE, HCTZ, and a multivitamin daily. She had a UTI 6 weeks ago that did not improve after a 5 day course…
Urinary sediment microscopy is a diagnostic technique designed to acquire 2-dimensional images of structures present in a slide. However, 2-dimensional views may lack sufficient contrast to allow for optimal visualization. One way to enhance the images and create…
“What am I looking at? ” Phagocytosis and particle internalization by cells in the urine is not common, but of clinical interest when it occurs.Phagocytosis/particle internalization can be observed in urine microscopy by the usual culprits: professional phagocytes…
One of the welcome side-effects of doing your own urine sediment examination is having easy access to a microscope and some basic lab equipment. This allows you to examine all sorts of things besides urine (Fig. 1). For…