Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute tubular injury • Nondysmorphic red - cells Non-glomerular bleeding from anywhere in the urinary tract • Dysmorphic red cells - Glomerular disease, but can also be seen if urine sample is not fresh at time of microscopy • Red cell casts - Diagnostic of glomerular disease • Leukocytes - Up to 3 per high-power field = normal; >3 per high-power field = inflammation in urinary tract • White cell casts - Renal infection • Hyaline casts - Any type of renal disease • Granular casts - More significant renal disease • “Muddy brown cast” - Necrotic tubular cells aggregated with tamm horsfall protein indicating acute tubular injury • Crystals - Some crystals can be found in healthy individuals; “abnormal” crystals may indicate metabolic disorders or excreted medications • Bacteria - Urinary tract infection; contamination #Urine #Microscopy #Atlas #key #diagnosis #nephrology #casts
