Atlas of Urine Microscopy Findings

 • Epithelial cells - Normal

 • Renal tubular cells - Acute tubular injury

 • Nondysmorphic red - cells Non-glomerular bleeding from anywhere in the urinary tract

 • Dysmorphic red cells - Glomerular disease, but can also be seen if urine sample is not fresh at time of microscopy

 • Red cell casts - Diagnostic of glomerular disease

 • Leukocytes - Up to 3 per high-power field = normal; >3 per high-power field = inflammation in urinary tract

 • White cell casts - Renal infection

 • Hyaline casts - Any type of renal disease

 • Granular casts - More significant renal disease

 • “Muddy brown cast” - Necrotic tubular cells aggregated with tamm horsfall protein indicating acute tubular injury

 • Crystals - Some crystals can be found in healthy individuals; “abnormal” crystals may indicate metabolic disorders or excreted medications

 • Bacteria - Urinary tract infection; contamination



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