Format

Send to:

Choose Destination
See comment in PubMed Commons below
Nephron Clin Pract. 2008;110(3):c145-50. doi: 10.1159/000166605. Epub 2008 Oct 27.

Urinary sediment cast scoring index for acute kidney injury: a pilot study.

Author information

  • 1Department of Critical Care Medicine and Anesthesiology, George Washington University Medical Center, Washington, DC 20037, USA. lchawla@mfa.gwu.edu

Abstract

BACKGROUND/AIMS:

Urine microscopy is a useful diagnostic tool; however, the manner in which nephrologists prepare and examine urinary sediment is variable. We developed an acute kidney injury (AKI) cast scoring index (CSI) in order to standardize urinary microscopy. Further, we sought to assess the precision of this scoring system.

METHODS:

Urine from 30 patients with AKI consistent with the syndrome of acute tubular necrosis were collected. Sample preparation was uniform and standardized. A panel of 3 nephrologists blinded to the sample preparation were instructed to grade each slide using the AKI CSI. Subsequently, the AKI CSI was then tested in another 18 patients with AKI to determine if this score could predict nonrenal recovery.

RESULTS:

The inter-observer agreement index was 99.80%, with a coefficient of variation of 1.24%. Of the 90 paired observations, 98.8% fell within 2 standard deviations of the mean, signifying good agreement. The receiver operator characteristic area under the curve for AKI CSI to predict nonrenal recovery was 0.79.

CONCLUSIONS:

AKI CSI is a simple, novel, reliable scoring system to grade the degree of epithelial cell and granular casts present on urine microscopy. A standardized AKI CSI has the potential to incorporate urinary cast analysis into the advancing field of AKI diagnostics. These preliminary data endorse the notion that the AKI CSI may be useful in predicting renal outcomes.

Copyright 2008 S. Karger AG, Basel.

PMID:
18953176
[PubMed - indexed for MEDLINE]
PMCID:
PMC2605880
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for S. Karger AG, Basel, Switzerland Icon for PubMed Central
    Loading ...
    Write to the Help Desk