URINALYSIS.....diagnostic clues.

URINALYSIS can give us instant CLUES to  an underlying pathology...and is also a
frequent topic of the boards.  We'll review some common and (not so common) findings.



1.   CALCIUM OXALATE...usually associated with Ulcerative Colitis or Ethylene Glycol Poisoning.

2.   ERYTHROCYTE CASTS...Pathognomonic for Acute Glomerulonephritis (AGN)

3.   HYALINE CASTS....implies moderate to severe dehydration...eg. Prerenal Azotemia

4.   GRANULAR CASTS...imlplies necrotic insult, such as Acute Tubular Necrosis (ATN)

5.   MUDDY BROWN CASTS....usually due to Acute Tubular Necrosis. (ATN)

6.   EOSINOPHILURIA.....very suggestive of ALLERGIC Interstitial Nephritis.
                                             (Best diagnosed with use of Hansel's stain).

7.   WHITE CELL CASTS...also commonly found in ALLERGIC Interstitial Nephritis.

8.   STERILE PYURIA...is a classic finding in Acute Interstitial Nephritis. (AIN).

9.   TUBULORETIC INCLUSIONS....pathognomonic for renal manifestation of HIV.

10.  URINE OSMOLALITY....reflects the kidneys ability to process water 
                                               An INCREASED osmolality = Concentrated urine (dehydration).
                                               An DECREASED osmolality = DILUTE urine.



Thanks for your time...be back shortly.