Principles of Clinical Pathology
Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard in Toxicologic Pathology, 2018
Urine sediment is examined for the presence of cells (i.e., epithelial cells, WBCs, and RBCs), casts, crystals, bacteria, and other formed elements; results are only semiquantitative (e.g., 1+ to 3+). With few exceptions, significant test article–related effects on urine sediment (e.g., increased incidence of casts) are associated with microscopic findings that better characterize the nature and severity of the effect. Although urine sediment examination is a standard component of urinalysis in most nonclinical studies, the cost/benefit ratio is high. If nephrotoxicity is not considered a potential test article liability on the basis of early studies and drug class, eliminating urine sediment examination from the urinalysis presents little risk. However, if sediment detail is considered important (e.g., a unique crystal is suspected), the method of urine sample collection is critical, and a standard timed collection (e.g., overnight) may be inappropriate. Cystocentesis at necropsy, free catch, or a limited time collection (e.g., 2 h) may be necessary to avoid deterioration of formed elements in the sample.
Case Report: Unusual Clinical Presentation of Primary AL Amyloidosis
Gilles Grateau, Robert A. Kyle, Martha Skinner in Amyloid and Amyloidosis, 2004
The urine sediment is typically benign, due to the lack of inflammation. In non-diabetic adults with nephrotic syndrome, amyloidosis accounts for 12% of renal biopsies. End-stage renal disease develops in approximately 20% of subjects with nephrotic syndrome. Fewer than 5% show urinary proteins loss less than 150 mg/day. These occasional patients have different renal presentation because of different site of amyloid deposition, primarily limited to the vessels, leading to narrowing of the vascular lumens. 6,7 Even less common is heavy tubular deposition, potentially leading to signs of tubular dysfunction, such type 1 (distal) renal tubular acidosis or polyuria due to nephrogenic diabetes insipidus. Extremely rare is crescentic glomerulonephritis superimposed upon renal amyloidosis. In these cases acute renal failure is associated with an active urine sediment.8
Nephrology
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Pre-renal failure vs. acute tubular necrosis (ATN):1 Urine output: low in both.2 Urine osmolality: >500 in pre-renal failure; <350 in ATN.3 U/P osmolality ratio: 1.5:1 in pre-renal failure; 1.1:1 in ATN.4 U/P creatinine ratio: >20:1 in pre-renal failure; <20:1 in ATN.5 Urea/creatinine ratio: >20:1 in pre-renal failure; <20:1 in ATN.6 Urine Na+: <20 mmol/L in pre-renal failure; >50 mmol/L in ATN.7 Fractional Na+ excretion:2 <1 in pre-renal failure; >1 in ATN.8 Urine sediment: normal in pre-renal failure; cellular debris in ATN.
Predicting lupus flares: epidemiological and disease related risk factors
Published in Expert Review of Clinical Immunology, 2021
Samuel de Oliveira Andrade, Paulo Rogerio Julio, Diego Nunes de Paula Ferreira, Simone Appenzeller
Although male sex, younger age at disease and non-Caucasian ethnicity is associated with more severe disease, greater frequency of nephritis, accrual damage, and death, the association of these demographic variables with flares are inconsistent in the literature independently of the score used (SLEDAI-2 K, BILAG, lupus nephritis flare index) [5,8–10]. Its significance decreases when flare predictors are adjusted for socio-demographic and disease-related variables [8,78]. In longitudinal cohort studies longer disease duration has been independent risk factor for flares when using SLEDAI-2 K score [6]. SLE patients with nephritis, longer time to remission was an independent risk factor for renal flares, defined as the presence of at least two determinations: (a) increase in proteinuria by more than 2 g/24 hours, (b) active urine sediment, or (c) increase in creatinine 30% [11].
Evaluation of FUS-2000 urine analyzer: analytical properties and particle recognition
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2018
Miroslava Beňovská, Ondřej Wiewiorka, Jana Pinkavová
The urine sediment was prepared by a second laboratory technician, according to the European recommendation for routine identification method of urine particles [18]. Well-mixed 4 ml of urine was centrifuged in conical test tubes at 400 g for 5 min. Then, 3.6 ml of the supernatant was discarded and sediment resuspended in the remaining 0.4 ml of sample volume in order to produce a tenfold concentrated urine sample solution. This was then transferred to a counting chamber Fast-read 102 (Biosigma s.r.l., Venice, Italy), where the particles of different categories were counted under the microscope. Evaluation of the elements was performed independently by the second laboratory technician based on her expertise with the support of information from an e-learning database, containing microscopic findings of stained and native sediment and findings from two automatic analyzers: iQ 200 (Iris, Chatsworth, CA) and FUS-2000 (Dirui, Changchun, China) [19].
Dipstick analysis of urine chemistry: benefits and limitations of dry chemistry-based assays
Published in Postgraduate Medicine, 2020
Varun Kavuru, Tommy Vu, Lampros Karageorge, Devasmita Choudhury, Ryan Senger, John Robertson
The analysis of urine physical properties, chemical constituents, and suspended particulates (cells, crystals, and biological debris) has been an important medical diagnostic procedure for thousands of years [3,4]. Simple, inexpensive testing (visual observation of color and turbidity, odor detection, refractometry for determination of specific gravity, and dipstick analysis of common/diagnostically important chemical constituents) can and is often done by physicians and trained health-care professionals in point-of-care (POC) settings (offices and hospitals). Microscopic analysis of suspended particulates (‘urine sediment’) is best done by those trained in urine sediment analysis and typically occurs in the clinical laboratories. The evaluation of urine sediments is not discussed in this review.
Related Knowledge Centers
- Albumin
- Collecting Duct System
- Distal Convoluted Tubule
- Microscopy
- Nephron
- Proteinuria
- Urine
- Kidney
- Uromodulin
- Mucoprotein