Biomarkers of Acute Renal Failure

Urinanalysis: A Traditional Biomarker of AKI

August 2009

This table indicates how the urinalysis can be used to help categorize patients that have evidence for acute kidney injury, by which we usually mean an elevated serum creatinine. If the decrease in renal function is entirely prerenal in nature and due to decreased renal blood flow, then we would expect to find no formed elements in the urine. In acute tubular necrosis, one can find renal epithelial cells, granular casts, and renal epithelial cell casts. For infection, one might expect to find white cells and white cell casts. Patients with nephrotic renal disease will have evidence for lipid casts and oval fat bodies, while patients with glomerulonephritis often will have the red cells, red blood cell casts, and dysmorphic red cells. The next few slides will show some images to demonstrate what these look like.

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Jump to section:

• Introduction
• Acute Kidney Injury
• Common Causes of Acute
• Progression From Pre-renal to Acute Tubular Necrosis
• Towards a Kidney Troponin
• Origin of Formed Elements in Urinalysis
• Urinanalysis: A Traditional Biomarker of AKI
• Hyaline Casts
• Renal Epithelial Cell Cast
• Leukocyte Cast
• RBC Cast
• Pigmented Cast
• Granular Cast
• Other Helpful Indices
• Potential Sources of Urinary Biomarkers
• NGAL as a Biomarker
• Studies Support NGAL as a Biomarker of AKI in the Following Situations
• Mayo Renal Laboratory Urinary NGAL Normals
• Normal Urinary NGAL Levels are Not Dependent on Age, but are Higher in Women than Men
• Ongoing Mayo Clinic Clinical Validation Study
• Ongoing Mayo Clinic Clinical Validation Study: Preliminary Results
• Study
• Other Potential Markers on the Horizon
• Mayo Clinic Goals
• Conclusions
• References
• Questions?