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MCQ – 97957

Question

Which one of the following parameters suggests pre-renal azotemia?
A.

Renal tubular epithelial cell casts

B.

Granular casts in urine sediment

C.

Hyaline casts in urine sediment

D.

Fractional excretion of sodium > 1%

Show Answer

Correct Answer � C

Explanation

Pre-Renal Azotemia:

    • Pre-renal azotemia is caused by decreased renal perfusion (e.g., hypovolemia, heart failure). The kidney structure remains intact.
    • It is reversible if the underlying cause is corrected.

Key Features Suggesting Pre-Renal Azotemia:

    • Hyaline casts: These are typically observed in pre-renal azotemia due to dehydration and low urine flow, causing precipitation of Tamm-Horsfall proteins.
    • Fractional excretion of sodium (FENa): It is usually

Why Other Options Are Incorrect:

    • Renal tubular epithelial cell casts (A): Suggestive of acute tubular necrosis (intrinsic renal pathology).
    • Granular casts (B): Indicative of intrinsic renal disease, such as acute tubular necrosis.
    • FENa > 1% (D): Found in intrinsic renal failure where sodium excretion is impaired.
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