Urine findings typical of glomerular disease with nephritic syndrome include which of the following?

• A. White blood cell casts
• B. Red blood cell casts
• C. Crystals
• D. Eosinophils in urine

Answer: (B)

Glomerular damage in nephritic syndrome causes red blood cells to leak into the filtrate. As these red cells pass through the tubules, they can be captured in a protein matrix to form red blood cell casts. This combination—hematuria with RBC casts—strongly indicates a glomerular source of bleeding rather than a problem lower in the urinary tract. White blood cell casts are more typical of tubulointerstitial inflammation or infection, crystals point to stones or crystal-induced injury, and eosinophils in urine suggest drug-induced interstitial nephritis. So red blood cell casts are the characteristic finding in glomerular disease with nephritic syndrome.