Daisy-like crystals: Not just the result of sampling artifact and not only in urine.

peer reviewe

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

AbstractBackgroundCasts 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.MethodsProspective study for the search and count of waxy casts in the urinary sediment of patients with different types of glomerular diseases.ResultsWaxy 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).ConclusionsWaxy 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

A Theoretical and Practical Course on Urine Microscopy in Nigeria: A Model for Nephrological Skill Transfer

&lt;i&gt;Background:&lt;/i&gt; In the developing world, the diagnostic power of nephrologists is heavily limited by financial, technical and human resource constraints. Urine microscopy (UM) is a basic, inexpensive and relatively simple diagnostic tool, which supplies irreplaceable information. Recently, a theoretical and practical course on UM was organized during the 22nd annual meeting of the Nigerian Society of Nephrology. &lt;i&gt;Methods:&lt;/i&gt; The 2-day course was based on power point presentations and on examination of true urine samples by means of a microscope equipped with phase contrast, polarized light and a video camera for projection of the findings. &lt;i&gt;Results:&lt;/i&gt; The presentations described were the methodology, the particles of the urine sediment and their clinical interpretation, the urine sediment in different clinical conditions, and 12 clinical cases, which demonstrated the value of UM in clinical practice. Practical sessions showed the most important urine particles, and how they could be identified and combined into urine profiles. More than 97% of the participants found the course to be useful and practicable and a UM program was actually started in 1 Nigerian center a few days after the course. &lt;i&gt;Conclusion:&lt;/i&gt; This course demonstrated that nephrological skills can be transferred from the developed to the developing world without large financial investments.</jats:p