Urinary sediment changes in severe preeclampsia

We analyzed the urinary sediment of 30 patients with severe preeclampsia every 4 hours during early labor, delivery, and the postpartum period. Fifteen normal control patients were also followed in a similar fashion. No casts were noticed in the urine samples of the control group. However, the urinary sediment of preeclamptic patients revealed the same uniform pattern regardless of the state of coagulation, or the presence or absence of oliguria or eclamptic seizures. Numerous granular and hyaline casts, red-cell, and tubular cell casts were identified during microscopic evaluation. These data reflect both glomerular and tubular damage in preeclampsia. We conclude that urinary sediment analysis in severe preeclampsia uniformly reflects renal parenchymal damage and does not correlate with or predict the clinical course of the disease.