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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 ...
Examples of urinary casts: a) RTE cell cast, b) "muddy" granular cast, c) white blood cell cast, d) red blood cell cast [112] Urinary casts are cylindrical structures composed of Tamm-Horsfall glycoprotein. Their shape derives from the renal tubules where they are formed, and the protein base can incorporate cells or other material. Hyaline ...
Lipiduria (lipids in urine) can also occur, but is not essential for the diagnosis of nephrotic syndrome. A few other characteristics seen in nephrotic syndrome are: The most common sign is excess fluid in the body due to serum hypoalbuminemia. Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues.
Urinalysis - After the patient provides a urine specimen, it is sent to the lab for analysis using a variety of methods including urine dipstick testing and microscopic examination. 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]
Diagnosis is made by a FENa (fractional excretion of sodium) > 3% and presence of muddy casts (a type of granular cast) in urinalysis. On histopathology, there is usually tubulorrhexis , that is, localized necrosis of the epithelial lining in renal tubules, with focal rupture or loss of basement membrane. [ 5 ]
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The color and volume of urine can be reliable indicators of hydration level. Clear and copious urine is generally a sign of adequate hydration. Dark urine is a sign of dehydration. The exception occurs when diuretics are consumed, in which case urine can be clear and copious and the person still be dehydrated.
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