How a skilful and motivated urinary sediment examination can save the kidneys

(Section Editor: A. Neyrier) In many nephrological units, urinalysis is carried out only by dipstick, whilst urine sediment examination is entrusted to the personnel of central laboratories, far from the bedside of the patient and without the knowledge of the clinical features of the patients [ 1 ]. The following case shows the importance that urine sediment examination still has in clinical practice, when it is carried out by nephrologists experienced in the field. On 16 September 1997, one of us (FGB) examined by phase contrast microscope the urine sediment of an outpatient, whose urine by dipstick was positive for haemoglobin (+++) and albumin (+). Urine sediment contained 50–60 erythrocytes/high power field (HPF) of glomerular type, i.e. >5% acanthocytes [ 2 ], 3–5 leucocytes/HPF, >1cast/low power field (hyaline, granular, epithelial and erithrocytic casts) and 3–5 renal tubular cells/HPF, which were intermingled with several fragments of tubular epithelium ( Figure 1 ).