urinary catheter

Casts are important components of urinary sediments, and their appearance often suggests substantial damage to the kidneys. It is a cylindrical structure formed by solidification of proteins in urine in the renal tubules and collecting tubes, so it is also called a cylinder. The formation of the cast type requires proteinuria, and the matrix formed is a Tamm-Horsfall glycoprotein. In 1966, Mcqueen further confirmed by fluorescent antibody method that various proteins of different molecular weights in plasma can be condensed on the transparent tubular substrate in the form of particles. In the pathological condition, due to the increased permeability of the glomerular basement membrane, a large amount of protein enters the renal tubule from the glomerulus, and in the renal distal convoluted tubule and collecting duct, acidification (increased acidity) and cartilage due to concentration (water absorption) In the presence of sulphate, the protein aggregates, precipitates, and forms a tube in the small renal cavity. Basic Information Specialist classification: growth and development check classification: urine / kidney function test Applicable gender: whether men and women apply fasting: fasting Tips: Do not exercise vigorously, maintain normal diet and rest. The middle part of the urine is taken for inspection. Normal value None; or a small amount of transparent tube type. (Note the specific reference value depends on each laboratory.) Clinical significance 1. The transparent tube type is occasionally visible in normal human urine. Less than 5,000 in 12 hours of urine. In severe exercise, fever, anesthesia, and cardiac insufficiency, a transparent cast can appear in the urine after stimulation of the kidney. A large number of diseases appear in acute and chronic glomerulonephritis, kidney disease, pyelonephritis, renal pelvis, malignant hypertension, renal arteriosclerosis and other diseases. In acute nephritis, the transparent tube type often coexists with other tube types in the urine, and the chronic interstitial nephritis patients can continue to appear in large amounts in the urine. 2, cell tube type (cellularcasts) is a tube type containing cell components, according to cell type can be divided into red blood cell cast, white blood cell cast and epithelial tubular cast. (1) Red blood cell cast (RsdCellCasts) The red blood cell cast is seen in the urine, suggesting that there is bleeding in the nephron, which can be seen in acute glomerulonephritis and acute exacerbation of chronic nephritis. Hemoglobin can also be seen in the blood type after blood transfusion after hemolysis and acute tubular necrosis, renal hemorrhage, renal transplant after the occurrence of rejection. Red blood cell casts may also be the only manifestations in systemic lupus erythematosus and other gelatinous disease, renal infarction, and renal vein thrombosis. (2) leukocyte casts (leucocytescasts) are common in acute pyelonephritis, interstitial nephritis, etc., patients with lupus erythematosus can also be seen. (3) Renal epithelial cell casts (renalepithelialcasts) are common in renal tubular diseases such as acute tubular necrosis, eclampsia, heavy metals, chemicals, drug poisoning, rejection after renal transplantation, and renal amyloidosis. Sometimes the cellular components in the tube type are difficult to distinguish, and they can be collectively called cell tube type. If necessary, they can also be distinguished by chemical staining. In the case of disseminated intravascular coagulation (DIC), platelet casts can appear in the urine, and phase contrast microscopy can be used. Or differentiated by McAb of anti-platelet membrane glycoprotein. 3, granular tube type can be seen in renal parenchymal lesions, such as acute and chronic glomerulonephritis, kidney disease, renal arteriosclerosis and so on. It can also be seen when drug poisoning damage occurs in renal tubular and renal transplantation. 4, renal insufficiency type (renalfailurecasts), also known as wide tube type (broadcasts), can be found in the urine of patients with renal insufficiency, suggesting that the kidney has severe urine retention. In patients with acute renal insufficiency, this type of cast can appear in large numbers in the early stage of polyuria, and gradually disappears as the renal function improves. Renal insufficiency occurs in the late stage of chronic nephritis, often indicating a poor prognosis. 5, mixed tube type mixed tube type tube type contains different cells and other formed parts, using pasteurization to help identify. Can be seen in patients with acute rejection after renal transplantation, ischemic renal necrosis, renal infarction and other patients. In the acute rejection reaction, a mixed cast of tubular epithelial cells and lymphocytes can be seen. 6, fat tube type in fat tube type (fattycasts) can be seen in the size of fat droplets with strong refraction, may also be embedded in the tubular epithelial cells containing fat droplets, can be identified by fat staining. It can be seen in chronic nephritis and lipid-induced nephropathy caused by epithelial cell steatosis after renal tubular injury, especially when it is more common in nephrotic syndrome. 7, waxy tube type (waxycasts) in the chronic damage of the nephron, long-term oliguria or anuria, the long-term retention of the granule tube or cell tube type in the renal tubules evolved, is the end of cell disintegration Produced; can also be formed by the dissolution of epithelial cells that have undergone amyloidosis. It does not dissolve in hypotonic solution, water and different pH media. Its appearance suggests severe lesions of renal tubules and poor prognosis. Can be seen in the late stage of chronic glomerulonephritis, renal insufficiency and renal amyloidosis; can also be seen in renal tubular inflammation and degeneration, renal transplant chronic rejection. 8, bacterial casts (bacterialcasts) are common in renal septic diseases. Fungal casts can be found in fungal infections, but they are difficult to identify and often need to be identified by bacteriology and special staining. The discovery of such casts allows early diagnosis of primary and disseminated fungal infections, and the use of antifungal drugs for near-monitoring has a role. 9. Crystalline tube type The tube-type transparent matrix contains crystals such as urate or oxalate. The clinical significance is similar to the corresponding crystalline urine. If the tube contains small round teeth, calcium citrate crystals are easily mistaken as red blood cell casts, should be carefully observed, can also be distinguished by cytochemical staining. 10, tube type, mucus and substances similar to the tube type (1) Cylindroidscasts are similar in shape to the tubular shape, but one end is twisted or twisted or spiraled. Because it often coexists with the transparent tube type, it can be seen in the urine of acute nephritis, and it is related to renal blood circulation disorder or kidney stimulation. (2) Mucous strands (mucousstrands) are long line-shaped, unclear edges, sharp curls at the ends, can be seen in normal urine, such as a large number of often expressed urinary tract irritation or inflammatory reaction. (3) Others include amorphous urate or phosphate clusters; cell clusters; other foreign materials such as cotton, wool, hemp fibers, hair and scars on the slides, etc., should be identified with the tube type. High results may be diseases: acute glomerulonephritis, chronic glomerulonephritis precautions Before the test: Do not exercise vigorously, maintain normal diet and rest. At the time of examination: a part of the urine is discharged first to wash away the bacteria remaining in the urethra and the anterior urethra, and then the middle part of the urine is taken for examination. Inspection process The urine of the subject was collected and examined by microscopy. Not suitable for the crowd Generally no taboos. Adverse reactions and risks No.