ArticleClinical journal of the American Society of Nephrology : CJASN2008
Diagnostic value of urine microscopy for differential diagnosis of acute kidney injury in hospitalized patients.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 1 of them a synthesis that pooled it.
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Who cites it
65 citing papers in PubMed, 1 synthesis or guideline pooled it, 195 citations in OpenAlex.
- Acute tubular necrosis and pre-renal acute kidney injury: utility of urine microscopy in their evaluation- a systematic review.International urology and nephrology · 2010Pooled it
- Does combining urine sediment examination to renal cell arrest and damage biomarkers improve prediction of progression and mortality of sepsis associated acute kidney injury?BMC nephrology · 2025Trial
- Adjudication of etiology of acute kidney injury: experience from the TRIBE-AKI multi-center study.BMC nephrology · 2014Trial
- The Utility of Urine Microscopy Score for Early Detection and Prediction of Acute Kidney Injury in At-Risk Patients.Kidney360 · 2025Article
- Understanding acute kidney injury in cirrhosis: Current perspective.World journal of hepatology · 2025Review
- An updated approach to the evaluation of the urinary sediment.Pediatric nephrology (Berlin, Germany) · 2025Review
- Changes in the composition of urine over six hours using urine dipstick analysis and automated microscopy.BMC nephrology · 2025Article
- Dimensions of muddy brown granular casts in patients with acute tubular injury.The American journal of the medical sciences · 2024Article
- Renal-Limited Presentation of Hydralazine-Induced Anti-neutrophil Cytoplasmic Antibody Vasculitis: A Case Report.Cureus · 2024Article
- Renal resistive index measurements by ultrasound in patients with liver cirrhosis: Magnitude and associations with renal dysfunction.World journal of radiology · 2024Article
- The Effects of Coenzyme Q10 on Contrast-Induced Acute Kidney Injury in Type 2 Diabetes: A Randomized Clinical Trial.Chonnam medical journal · 2024Article
- Urine Parameters in Patients with COVID-19 Infection.Life (Basel, Switzerland) · 2023Review
- Longitudinal tracking of acute kidney injury reveals injury propagation along the nephron.Nature communications · 2023Article
- Biomarkers in acute kidney injury: On the cusp of a new era?The Journal of clinical investigation · 2023Article
- Recent Advances in the Management of Hepatorenal Syndrome: A US Perspective.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Renal Assessment in Acute Cardiorenal Syndrome.Biomolecules · 2023Review
- Identification of Pre-Renal and Intrinsic Acute Kidney Injury by Anamnestic and Biochemical Criteria: Distinct Association with Urinary Injury Biomarkers.International journal of molecular sciences · 2023Article
- Urine testing to differentiate glomerular from tubulointerstitial diseases on kidney biopsy.Practical laboratory medicine · 2022Article
- Urine Sediment Exam Provides More Diagnostic Information in AKI than Novel Urinary Biomarkers: COMMENTARY.Kidney360 · 2022Article
- Urine Sediment Exam Provides More Diagnostic Information in AKI than Novel Urinary Biomarkers: PRO.Kidney360 · 2022Article
5 more citing papers are in PubMed but not listed here.
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5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesUrine microscopy is the oldest and one of the most commonly used tests for differential diagnosis of acute kidney injury (AKI), but its performance has not been adequately studied in the setting of AKI. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Fresh urine samples were obtained from 267 consecutive patients with AKI, and urinary sediment was examined. The cause of AKI was assessed at two time points: (1) Before urine microscopy diagnosis and (2) after patient discharge or death (final diagnosis). A urinary scoring system also was created on the basis of casts and renal tubular epithelial cells (RTEC) to differentiate acute tubular necrosis (ATN) from prerenal AKI.
resultsThe urinary sediment scoring system was highly predictive of the final diagnosis of ATN. In patients with a high pretest probability of ATN (initial diagnosis of ATN), any casts or RTEC (score > or =2) resulted in very high positive predictive value and low negative predictive value for a final diagnosis of ATN. In patients with a low pretest probability of ATN (initial diagnosis of prerenal AKI), lack of casts or RTEC on urinary sediment examination had a sensitivity of 0.73 and specificity of 0.75 for a final diagnosis of prerenal AKI. The negative predictive value of lack of casts or RTEC in patients with low pretest probability of disease was 91%.
conclusionsUrine sediment examination is a valuable diagnostic tool for confirming the diagnosis of ATN. A score of > or =2 on an ATN urinary sediment scoring system is an extremely strong predictor of ATN.
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