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Waxy casts are broad casts, which is a more general term to describe the wider cast product of a dilated duct, and are seen in chronic kidney failure. In nephrotic syndrome, many additional types of casts exist, including broad and waxy casts if the condition is chronic (this is referred to as a telescopic urine with the presence of many casts ...
Most types of RPGN are characterized by severe and rapid loss of kidney function with marked hematuria; red blood cell casts in the urine; and proteinuria sometimes exceeding three grams in twenty-four hours, a range associated with nephrotic syndrome. Some patients also experience hypertension and edema.
The interpretation of urinalysis takes into account the results of physical, chemical and microscopic examination and the person's overall condition. Urine test results should always be interpreted using the reference range provided by the laboratory that performed the test, or using information provided by the test strip/device manufacturer. [136]
Because the kidney is responsible for making urine, analyzing the urine directly can provide crucial data that can help the physician diagnose nephritic syndrome. [33] Some findings on urinalysis that are consistent with nephritic syndrome include red blood cells , red blood cell casts, proteinuria, and possibly white blood cells . [9]
A urine dipstick test may also give an incorrect positive result for hematuria if there are other substances in the urine such as myoglobin, a protein excreted into urine during rhabdomyolysis. A positive urine dipstick test should be confirmed with microscopy, where hematuria is defined by three or more red blood cells per high power field. [6]
Specifically, the presence of nitrite and white blood cells on a urine test strip in patients with typical symptoms are sufficient for the diagnosis of pyelonephritis, and are an indication for empirical treatment. Blood tests such as a complete blood count may show neutrophilia.
The diagnosis is often made based on the medical history, blood samples, and a urine sample. The absence of urine RBCs and RBC casts microscopically despite a positive dipstick test suggests hemoglobinuria or myoglobinuria. The medical term for RBCs in the urine is hematuria.
In urine tests, patients are given a week of restricted calcium diet, and their urine samples are collected for two days to assay calcium in the urine. Urine tests with hypercalciuria should result in a 0.2 mg/mg ratio between calcium and creatinine. If calcium excreted in urine is measured to be lower than 0.07 mmol/kg after 24 hours, diet ...