Figure 1216

White blood cells (WBCs) can also be present in small numbers in the urine of patients with ARF. Large numbers of WBCs and WBC casts strongly suggest the presence of either pyelonephritis or acute interstitial nephritis. Eosinolphiluria (Hansel's stain) is often present in either allergic interstitial nephritis or atheroembolic disease [13, 14]. Renal tubular epithelial (RTE) cells and casts and pigmented granular casts typically are present in pigmenturia-associated ARF (see Fig. 12-21) and in established acute tubular necrosis (ATN). The presence of large numbers of crystals on urinalysis, in conjunction with the clinical history, may suggest uric acid, sulfonamides, or protease inhibitors as a cause of the renal failure.

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