WE define acute glomerulonephritis as the sudden appearance of hematuria, proteinuria, and red-cell casts. The last finding, which rarely occurs in other types of renal disease,1 is virtually diagnostic of active glomerular inflammation. The clinician should carefully examine the urinary sediment for red-cell casts and should not delegate this critical test to the laboratory performing routine urinalysis. In the absence of such casts, dysmorphic red cells in the urine viewed under a phase-contrast microscope have also been shown to correlate closely with active glomerular disease.2 Hematuria, which is virtually always present, can be persistent or intermittent, gross or microscopic. Proteinuria.
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