In chronic kidney disease, which urinalysis finding is associated with end-stage renal disease?

In chronic kidney disease, which urinalysis finding is associated with end-stage renal disease?

• A. Red blood cell casts
• B. Hyaline casts
• C. Broad waxy casts
• D. White blood cell casts

Answer: (C)

Casts in the urine reflect the level of tubule damage, and their appearance changes with disease severity. In chronic kidney disease, especially as it progresses to end-stage renal disease, tubules become dilated and chronically damaged, so_cast material accumulates into broad, waxy forms. The broad width indicates dilated tubules and longstanding injury, while the waxy, glossy look comes from degenerating, aging casts. This combination—broad and waxy—is a hallmark of advanced, long-standing renal damage and aligns with ESRD. By contrast, red blood cell casts signal glomerular bleeding, hyaline casts are nonspecific and common in concentrated urine or prerenal states, and white blood cell casts point to tubulointerstitial inflammation or infection.

Casts in the urine reflect the level of tubule damage, and their appearance changes with disease severity. In chronic kidney disease, especially as it progresses to end-stage renal disease, tubules become dilated and chronically damaged, so_cast material accumulates into broad, waxy forms. The broad width indicates dilated tubules and longstanding injury, while the waxy, glossy look comes from degenerating, aging casts. This combination—broad and waxy—is a hallmark of advanced, long-standing renal damage and aligns with ESRD. By contrast, red blood cell casts signal glomerular bleeding, hyaline casts are nonspecific and common in concentrated urine or prerenal states, and white blood cell casts point to tubulointerstitial inflammation or infection.