Renal Pathophysiology

CHAPTER 8 Urinalysis and Approach to the Patient With Renal Dysfunction

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CHAPTER 8 Urinalysis and Approach to the Patient With Renal Dysfunction

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„ PLATE 8.1. Casts in the urine sediments. A. Granular cast. These can normally be seen in the urine. There are renal tubular epithelial cells; white blood cells and red blood cells present as well. B. Red blood cell cast. Although this cast contains tightly packed red cells, it is more common to see fewer red cells trapped within a hyaline or granular cast. C. Fatty cast. The fat droplets within this cast can be differ entiated from red cells by their dark outlines and variable size. D. Under polarized light, the fat droplets within this cast show the characteristic “Maltese cross” ap pearance and are characteristically seen in diseases associated with the nephrotic syndrome. E. White blood cell cast, which can be seen with infection or allergic reactions. F. Muddy brown casts. These casts are named for the pigment giving rise to the typical color of these casts seen in the urine sediment. They are characteris tically seen in patients with acute tubular necrosis; they contain necrotic debris and degenerated epithelial cells.

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