Which urinalysis findings are characteristic of poststreptococcal glomerulonephritis?

Updated: Dec 16, 2020
  • Author: Duvuru Geetha, MD, MRCP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Findings are as follows:

  • Results are always abnormal

  • Hematuria and proteinuria are present in all cases

  • Urine sediment has red blood cells, red blood cell casts, white blood cells, granular casts, and, rarely, white blood cell casts

  • Dysmorphic red blood cells indicative of glomerular hematuria can usually be detected by performing phase-contrast microscopy

  • Red blood cell casts are best detected in first, early-morning urine specimens examined by the physician immediately after the patient voids

  • Hematuria usually resolves within 3-6 months but may persist as long as 18 months

  • Microscopic hematuria may be present in patients in whom the disease has otherwise clinically resolved

  • Proteinuria may be mild or so severe that it causes nephrotic syndrome

  • Approximately 5-10% of patients with APSGN have nephrotic-range proteinuria

  • Proteinuria usually disappears in 6 months. A mild increase in urinary protein excretion is present in 15% at 3 years and 2% at 10 years

  • Patients with nephrotic-range proteinuria in the acute phase or persistent heavy proteinuria have a worse prognosis. This is often associated with an evolution to a garlandlike pattern of immune deposits as the disease progresses


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