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Urine Microscopy and Casts - Image Atlas Key

- Squamous Epithelial Casts
- Transitional Epithelial Cells
- Renal Tubular
Urine Microscopy ... and Casts - Image ... Transitional Epithelial Cells ... Tubular Epithelial Cell ... #Casts #Atlas #
Atlas of Urine Microscopy Findings
 • Epithelial cells - Normal
 • Renal tubular cells - Acute
• Red cell casts ... casts - Renal infection ... • Hyaline casts ... disease • Granular casts ... diagnosis #nephrology #casts
Causes of Acute Kidney Injury (AKI) - Differential Diagnosis Algorithm
Acute Kidney Injury (AKI) - Acute increase
Causes of Acute ... Necrosis (Epithelial cell ... casts) • Ischemia ... Obstruction • Cast ... polyangiitis /microscopic
Urine Microscopy - Casts
Acellular Casts
 • Hyaline Casts - Consists of only precipitated Tamm-Horsfell protein without
Urine Microscopy ... - Casts Acellular ... suggestive of acute ... in a variety of acute ... #Urine #Microscopy
Algorithmic Approach to Acute Interstitial Nephritis
When to suspect AIN? (not sensitive)
 • AKI, AKD, rapidly progressive
Algorithmic Approach ... to Acute Interstitial ... sterile pyuria, WBC casts ... eosinophiluria, microscopic ... proteinuria, granular casts
Acute Kidney Injury - Differential Diagnosis Framework
PRERENAL:
 - Intrarenal vasoconstriction-hemodynamically mediated
 - Systemic vasodilation
 - Volume
Acute Kidney Injury ... casts on UA) - ... casts or pigmented ... casts on UA) - ... appropriate) #Acute
Urinary Casts and Disease Associations
Hyaline - May be nonspecific; seen in normal individuals or during severe
Urinary Casts and ... breakdown of cellular casts ... heme-granular casts ... are seen in acute ... 34t5DgJ #Urinary #Casts
Causes of Hematuria - Differential Diagnosis Algorithm
Red blood cells on urine microscopy. Must exclude false positives
Causes of Hematuria ... Differential Diagnosis Algorithm ... Red blood cells ... on urine microscopy ... RBCs and/or RBC casts
Simplified Approach to Acute Kidney Injury (AKI)
1) IS THIS AN EMERGENCY? 
Is there a dialysis indication
Simplified Approach to Acute ... PROBLEM ~80% of AKI cases ... are caused by prerenal ... Assess UA w/ microscopy ... for WBCs, RBCs, casts
Examples of varying granular and granular/waxy mixed casts: 
A: coarse granular/broad-waxy (and surrounding white blood cells);
granular/waxy mixed casts ... surrounding white blood cells ... Granular #MuddyBrown #Casts ... #Urine #Microscopy