Waxy casts in the urinary sediment of patients with different types of glomerular diseases: results of a prospective study.

Abstract

BACKGROUND:

Casts are well known components of the urinary sediment. For most casts, the clinical associations are known and demonstrated, while for waxy casts they are totally unknown.

METHODS:

Prospective study for the search and count of waxy casts in the urinary sediment of patients with different types of glomerular diseases.

RESULTS:

Waxy casts were found in 39 out of 287 patients (13.6%), mostly in low number (1 to 9 out of 100 casts evaluated/sample). They were frequent in postinfectious glomerulonephritis and renal amyloidosis (5/9 patients, 44.5%, p=0.02 for each condition), while they were rare in membranous nephropathy (4/67 patients, 6.0%, 0.04) and absent in focal segmental glomerulosclerosis (0/23 patients, p=0.05). Waxy casts were associated significantly with higher serum creatinine levels (p<0.0001), with the presence of >1 leukocyte/HPF, granular casts and leukocytic casts (p=0.001 to 0.008) and with higher numbers of erythrocytes, leukocytes, renal tubular epithelial cells, granular casts, epithelial casts, and leukocytic casts (p<0.0001 to=0.03).

CONCLUSIONS:

Waxy casts are uncommon and few in patients with glomerular diseases and are associated with impaired renal function and with several other structures of the urinary sediment.

• Authors: Diana Spinelli, Dario Consonni, Giuseppe Garigali, Giovanni B Fogazzi
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 424 Pg. 47-52 (Sep 23 2013) ISSN: 1873-3492 [Electronic] Netherlands
• PMID: 23707859 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Chemical References

• Creatinine

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Amyloidosis (diagnosis, pathology, urine)
• Creatinine (blood)
• Erythrocytes (pathology)
• Female
• Glomerulonephritis (diagnosis, pathology, urine)
• Glomerulonephritis, Membranous (diagnosis, pathology, urine)
• Glomerulosclerosis, Focal Segmental (diagnosis, pathology, urine)
• Humans
• Kidney (pathology)
• Leukocytes (pathology)
• Male
• Middle Aged
• Prospective Studies
• Urinalysis
• Urinary Calculi (chemistry, urine)