title: Waxy casts in the urinary sediment of patients with different types of glomerular diseases: results of a prospective study.
abstract: BACKGROUND
  Casts are well known components of the urinary sediment. For most casts, the clinical associations are known and demonstrated, while for waxy casts they are totally unknown.
  
  
  METHODS
  Prospective study for the search and count of waxy casts in the urinary sediment of patients with different types of glomerular diseases.
  
  
  RESULTS
  Waxy casts were found in 39 out of 287 patients (13.6%), mostly in low number (1 to 9 out of 100 casts evaluated/sample). They were frequent in postinfectious glomerulonephritis and renal amyloidosis (5/9 patients, 44.5%, p=0.02 for each condition), while they were rare in membranous nephropathy (4/67 patients, 6.0%, 0.04) and absent in focal segmental glomerulosclerosis (0/23 patients, p=0.05). Waxy casts were associated significantly with higher serum creatinine levels (p<0.0001), with the presence of >1 leukocyte/HPF, granular casts and leukocytic casts (p=0.001 to 0.008) and with higher numbers of erythrocytes, leukocytes, renal tubular epithelial cells, granular casts, epithelial casts, and leukocytic casts (p<0.0001 to=0.03).
  
  
  CONCLUSIONS
  Waxy casts are uncommon and few in patients with glomerular diseases and are associated with impaired renal function and with several other structures of the urinary sediment.
authors.affiliation: Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Spinelli
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Garigali
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Fogazzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000175:diagnosis / Q000473:pathology / Q000652:urine*; D003404:Creatinine / Q000097:blood; D004912:Erythrocytes / Q000473:pathology; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000473:pathology / Q000652:urine*; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000473:pathology / Q000652:urine*; D005923:Glomerulosclerosis, Focal Segmental / Q000175:diagnosis / Q000473:pathology / Q000652:urine; D006801:Humans; D007668:Kidney / Q000473:pathology; D007962:Leukocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016482:Urinalysis; D014545:Urinary Calculi / Q000737:chemistry / Q000652:urine*
chemical_list: D003404:Creatinine
keywords: Glomerulonephritis; Urinalysis; Urinary casts; Urinary sediment; Waxy casts