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Crystal cast in patient with AKI and TLS on Urine Microscopy

Randy Luciano MD, PhD @RandyLucianoMD

#TLS #Crystal
Crystal cast in ... and TLS on Urine Microscopy ... RandyLucianoMD #TLS #Crystal ... #casts #crystalluria ... #Urine #Microscopy
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
Atlas of Urine Microscopy ... fresh at time of microscopy ... tubular injury • Crystals ... - Some crystals ... individuals; “abnormal” crystals
Urine Microscopy - Urinary Sediment Examination Instructions
Preparation of the urine for microscopic examination:
 • Clean catch
up by cells or casts ... Ill stain) and crystals ... RBC's, lipids, crystals ... protein matrix of casts ... identification of lipids, crystals
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Epithelial cell casts ... Obstruction • Cast ... myeloma) • Urate crystals ... polyangiitis /microscopic
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
PROBLEM ~80% of AKI cases ... Assess UA w/ microscopy ... for WBCs, RBCs, casts ... , crystals, protein
Urinalysis & Urine Sodium 
Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively
Microscopic exam ... • Crystals ... • Urinary casts ... #Urinalysis #crystals ... leucocyte-esterase #urine #UNa #casts
Urine Microscopy and Casts - Image Atlas Key

- Squamous Epithelial Casts
- Transitional Epithelial Cells
- Renal Tubular
Urine Microscopy ... and Casts - Image ... - WBC Cast - ... Cast - Waxy Cast ... JoseTesser) #Urine #Microscopy
Sulfa Crystals on Urine Microscopy
Sulfa Crystal!  Drug-induced crystalluria is a cause of acute renal failure
Sulfa Crystals on ... Urine Microscopy ... Sulfa Crystal! ... TELMALEMOS10 #Sulfa #Crystals ... #Urine #Microscopy
Hippuric Acid Crystals on Urine Microscopy

This crystal is present in the urine of people working with
Hippuric Acid Crystals ... on Urine Microscopy ... This crystal is ... crystalluria #Urine #Microscopy
Uric Acid Crystals on Urine Microscopy

Dr. Telma Lemos @TELMALEMOS10

#UricAcid #Crystals #Urine #Microscopy #clinical #nephrology
Uric Acid Crystals ... on Urine Microscopy ... #UricAcid #Crystals ... #Urine #Microscopy