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The Resurgence of Urine Microscopy

  • 1 Sana Shaikh is a Nephrology Fellow with Washington University School of Medicine, St. Louis, MO. Jay R. Seltzer is Chief of Nephrology, Missouri Baptist Medical Center, St. Louis, MO.
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Biochemical and microscopic examination of the urine is routinely utilized in the evaluation of patients with kidney disorders, and urine microscopy—by providing a view into what's happening in the kidneys—may at times be a surrogate for histologic testing and serve as a “liquid biopsy.”

Several studies have highlighted the benefits of urine microscopy. In patients with a high pretest probability of acute tubular necrosis (ATN), detection of granular casts or renal tubular epithelial cells (RTECs) has a very high positive predictive value and low negative predictive value (1). Application of a urinary sediment score (composite of number of

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