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

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• 作者：Diana Spinelli ; Dario Consonni ; Giuseppe Garigali ; Giovanni B. Fogazzi
• 关键词：Glomerulonephritis ; Urinalysis ; Urinary sediment ; Urinary casts ; Waxy casts
• 刊名：Clinica Chimica Acta
• 出版年：2013
• 出版时间：23 September, 2013
• 年：2013
• 卷：424
• 期：Complete
• 页码：47-52
• 全文大小：502 K

文摘

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.