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The clinical and pathological relevance of waxy casts in urine sediment

Although casts in urine may imply the underlying pathogenesis and the diagnosis, the waxy cast is poorly understood yet. We aim to investigate the association between waxy casts and clinicopathological indices. Patients undergone renal biopsy and urine sediment examination were enrolled. Waxy casts...

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Autores principales: Xu, Damin, Li, Jingzi, Wang, Suxia, Tan, Ying, Liu, Ying, Zhao, Minghui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246008/
https://www.ncbi.nlm.nih.gov/pubmed/35730180
http://dx.doi.org/10.1080/0886022X.2022.2088388
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author Xu, Damin
Li, Jingzi
Wang, Suxia
Tan, Ying
Liu, Ying
Zhao, Minghui
author_facet Xu, Damin
Li, Jingzi
Wang, Suxia
Tan, Ying
Liu, Ying
Zhao, Minghui
author_sort Xu, Damin
collection PubMed
description Although casts in urine may imply the underlying pathogenesis and the diagnosis, the waxy cast is poorly understood yet. We aim to investigate the association between waxy casts and clinicopathological indices. Patients undergone renal biopsy and urine sediment examination were enrolled. Waxy casts referred to those presented with a homogeneous melted wax appearance and pre-waxy casts referred to those in which one or more segments demonstrated a waxy-cast appearance. Multivariable logistic regression was used to assess the factors associated with waxy casts. In 1282 patients, the detection rate of waxy casts was 26.3%. If either waxy or pre-waxy cast was considered as a diagnostic marker for renal insufficiency (eGFR < 60 ml/min/1.73 m(2)), the sensitivity was 0.58 and the specificity was 0.88. If the only waxy cast was considered as the diagnostic marker, the sensitivity was 0.29 and the specificity was 0.97. The patients with waxy or pre-waxy casts had higher blood pressure, more proteinuria, and worse renal function. Waxy or pre-waxy cast was independently associated with eGFR (odds ratio: 0.73 per 10 mL/min/1.73 m(2) increase, 95% confidence interval: 0.69–0.77, p < 0.001), proteinuria (odds ratio: 1.07 per 1 g/day increase, 95% confidence interval: 1.03–1.10, p < 0.001) and pathological lesions. Waxy or pre-waxy casts are closely related to impaired renal function. Their presence is a specific indicator of renal insufficiency but is not sensitive enough.
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spelling pubmed-92460082022-07-01 The clinical and pathological relevance of waxy casts in urine sediment Xu, Damin Li, Jingzi Wang, Suxia Tan, Ying Liu, Ying Zhao, Minghui Ren Fail Clinical Study Although casts in urine may imply the underlying pathogenesis and the diagnosis, the waxy cast is poorly understood yet. We aim to investigate the association between waxy casts and clinicopathological indices. Patients undergone renal biopsy and urine sediment examination were enrolled. Waxy casts referred to those presented with a homogeneous melted wax appearance and pre-waxy casts referred to those in which one or more segments demonstrated a waxy-cast appearance. Multivariable logistic regression was used to assess the factors associated with waxy casts. In 1282 patients, the detection rate of waxy casts was 26.3%. If either waxy or pre-waxy cast was considered as a diagnostic marker for renal insufficiency (eGFR < 60 ml/min/1.73 m(2)), the sensitivity was 0.58 and the specificity was 0.88. If the only waxy cast was considered as the diagnostic marker, the sensitivity was 0.29 and the specificity was 0.97. The patients with waxy or pre-waxy casts had higher blood pressure, more proteinuria, and worse renal function. Waxy or pre-waxy cast was independently associated with eGFR (odds ratio: 0.73 per 10 mL/min/1.73 m(2) increase, 95% confidence interval: 0.69–0.77, p < 0.001), proteinuria (odds ratio: 1.07 per 1 g/day increase, 95% confidence interval: 1.03–1.10, p < 0.001) and pathological lesions. Waxy or pre-waxy casts are closely related to impaired renal function. Their presence is a specific indicator of renal insufficiency but is not sensitive enough. Taylor & Francis 2022-06-22 /pmc/articles/PMC9246008/ /pubmed/35730180 http://dx.doi.org/10.1080/0886022X.2022.2088388 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Xu, Damin
Li, Jingzi
Wang, Suxia
Tan, Ying
Liu, Ying
Zhao, Minghui
The clinical and pathological relevance of waxy casts in urine sediment
title The clinical and pathological relevance of waxy casts in urine sediment
title_full The clinical and pathological relevance of waxy casts in urine sediment
title_fullStr The clinical and pathological relevance of waxy casts in urine sediment
title_full_unstemmed The clinical and pathological relevance of waxy casts in urine sediment
title_short The clinical and pathological relevance of waxy casts in urine sediment
title_sort clinical and pathological relevance of waxy casts in urine sediment
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246008/
https://www.ncbi.nlm.nih.gov/pubmed/35730180
http://dx.doi.org/10.1080/0886022X.2022.2088388
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