尿沉渣鏡檢之圓柱體種類與血清腎絲球過濾率估計值之關聯性

The Correlations Between the Different Types of Urinary Casts and the Serum Estimated Glomerular Filtration Rate

尿沉渣鏡檢中常可發現圓柱體，然而，圓柱體種類與腎功能估計值的關聯性尚未有文獻明確的探討。本研究共收集20-70歲之受試者共324位，依慢性腎病分期而分為5組。統計結果指出，血清肌酸酐值正常且腎功能估計值大於90的受試者，出現透明圓柱體的頻度最高，且細胞性圓柱體、顆粒性圓柱體與蠟狀圓柱體也會出現，這代表可能患有早期局部節段性腎絲球硬化症。腎功能衰竭的第5群受試者，觀察到顆粒性圓柱體的頻度最高，蠟狀圓柱體居次。

Background: Urinary casts are a common finding in urine sediment microscopy. However, the correlation between the types of casts and the glomerular filtration rate has been seldom investigated.
Methods: There were 342 volunteers, in the 20-70 age range, enrolled in this study. According to the serum creatinine level and the age with the modification of diet in renal disease equation, these volunteers were assigned into 5 groups based on the defined stages of chronic kidney disease (CKD). The protocol for urine sediment microscopy followed the urine sediment guideline published by the Taiwan Society of Laboratory Medicine. The findings of hyaline cast, cellular cast, granular cast, or waxy cast of urine sediment microscopy were recorded.
Results: The hyaline cast, cellular cast, granular cast, and waxy cast were found in stage 1 of CKD. The frequency of the hyaline cast was the highest. The hyaline cast, cellular cast, granular cast, and waxy cast were also found in stage 5 of CKD. The frequency of the granular cast was the highest.
Conclusion: The hyaline cast, cellular cast, granular cast, and waxy cast can be found in stage 1 of CKD. Focal segmental glomerulosclerosis (FSGS) could be accounted for this phenomenon.