Urine Sediment

Description:

This book is a comprehensive resource and up-to-date description of all urinary sediment constituents which are presented in bright-field mode and in phase-contrast mode. Thanks to numerous detailed images of urinary sediment constituents, the reader is able to easily compare what they view microscopically with high-resolution photographs and short films. The book is also designed to aid the identification of rare urine constituents in their native state without prior staining. It also features guidance on how set-up a microscope , microscopy techniques, and  preanalytics. Exercises focused on microscopic analysis and diagnosis and a urinary sediment quiz reinforce key concepts to aid learning.

Urine Sediment provides a practically applicable guide to the recognition of urinary sediment constituents. It is therefore a critical resource for trainees and experienced practitioners in urology, nephrology, gynecology and general practice who need to be able to accurately and quickly identify urine sediment constituents.

Preface

The inspection of urine has been of particular relevance in the identification of diseases for almost 2000 years. The urine glass, known as the matula, was even the status symbol for physicians in the Middle Ages. As a result of the automation of laboratory diagnostics and the introduction of urine test strips, a considerable portion of urine diagnostics can be standardized now. However, when it comes to the analysis of urine sediment, an experienced diagnostician is by far superior to automated urine sediment analysis.

In her book, Josefine Neuendorf presents all the information needed for urinary sediment analysis, from obtaining urine, pre-analytics, and analysis to urine sediment diagnosis in a clear and concise manner. Each of these analytical steps on the way to reliable diagnosis based on urine sediment are made clear and convincing thanks to the easy-to-understand presentation of the basic principles on the one hand, and the detailed explanations on differentiating morphological details on the other. The 3rd edition of the book has gained considerably from the clear depiction of urinary sediment constituents using high-resolution images of urine sediment.

Well performed urinary sediment analysis can make a valuable contribution to the differential diagnoses of acute kidney diseases, especially when the arguments for the various differential diagnoses need to be weighed up in a timely manner. Properly obtained and correctly interpreted findings of urinary sediment analysis can support the indication for kidney biopsy or the decision to initiate treatment immediately.

Questions on urine sediment are also part of exams. Thus, according to the catalog of learning targets issued by the German Institute for Medical and Pharmaceutical Examination Questions (IMPP), students should be familiar with performing urinary sediment analysis. In particular, the differentiation of glomerular from non-glomerular erythrocyturia is an important examination topic, which is tested by asking students to identify acanthocytes on images of urine sediment. Moreover, the German Specialty Training Regulations for Nephrology call for experience and skills in the performance of—and reporting of findings from — microscopic analysis of urine sediment, including phase contrast microscopy. This book provides a clear explanation of all these aspects.

Therefore, the book “Urine Sediment” represents not only a valuable aid in daily practice, but also during studies and continuing education.

Table of contents :

Foreword
Preface
Acknowledgments
Contents
Abbreviations
About the Author
Part I
1: The Microscope
1.1 Structure of the Microscope
1.2 Cleaning and Maintaining the Microscope
1.3 Servicing the Microscope
1.4 Light Bulb Replacement
2: Setting-Up Köhler Illumination
2.1 Setting-Up Köhler Illumination or Aligning the Microscope
2.2 Quick Guide to Setting-Up Köhler Illumination
Reference
3: Phase-Contrast Microscopy
3.1 Application
3.2 What Is Required for Changeover?
3.3 The Light Pathway of Phase-Contrast Microscopy
3.4 Phase-Contrast Microscopy Equipment
3.4.1 PhaCo Objective
3.4.2 PhaCo Condensers
3.5 Centering the Phase Rings
4: Macroscopic Urinalysis
4.1 Color
4.1.1 Some Examples
4.2 Odor
4.2.1 Some Examples
4.3 Cloudiness
4.3.1 Some Examples
5: Microscopic Urinalysis
5.1 Urine Sediment Preparation
5.1.1 Performance
5.2 Error Checklist and Tips for Urine Sediment Preparation
5.3 Discussion: Types of Centrifuge (Fig. 5.2)
5.4 Centrifuge Nomogram
5.5 Preparing the Native Sample
5.5.1 Materials (Fig. 5.4)
5.5.2 Performance
5.6 Switching the Microscope Between Bright-Field and Phase-Contrast
5.6.1 Switching the Microscope from Bright-Field to Phase-Contrast Microscopy
5.6.2 Switching the Microscope from Phase-Contrast to Bright-Field Microscopy
5.7 Specimen-Specific Adjustment of the Microscope
5.8 Semi-quantitative Analysis/Units
5.9 Discussion: Field Number and Normal Values
6: Anatomy of the Kidneys and Urinary Tract System
7: Description of Urinary Sediment Constituents
7.1 Erythrocytes
7.1.1 Hematuria (Increased Excretion of Erythrocytes in Urine)
7.1.2 Eumorphic Erythrocytes—NR: 0–1/HPF
7.1.2.1 Biconcave, Disc-Shaped Erythrocytes (pH = 6)
7.1.2.2 Thorn Apple-Shaped Erythrocytes (pH  6)
7.1.3 Dysmorphic Erythrocytes
7.1.4 Acanthocytes—NR: