[The cytology of the urinary sediment in the differential diagnosis of the complications in patients with kidney allografts].

Urine sediment from 56 renal transplant recipients was tested cytologically. The recipients had 7 episodes of acute rejection (AR), 8 episodes of cyclosporin nephrotoxicity (CNT), acute tubular necrosis (ATN), combined complications, bacterial infection in 11, 6 and 16 cases, respectively. 12 patients had stable renal function. Cytospin preparations were made for Pappenheim staining. FACScan cytograms were obtained based on light scattering (cell size and granularity). Low cell count in patients with stable renal function and higher levels of mononuclear cells in all cases of a complicated postoperative period were seen. In acute tubular necrosis the sediment had a high scatter pattern, i.e. high density and large particles, while in cyclosporin nephrotoxicity renal epithelial cells had a low scatter pattern. Polymorphs were typical of the bacterial infection and acute tubular necrosis. Acute rejections were associated with elevated lymphocyte number. Microscopic examination revealed predominance of collect duct cells, lymphocytes with morphological signs of activation in acute rejection and proximal tubular cells in cyclosporin nephrotoxicity. Episodes of combined complications were difficult for diagnosis due to their mixed cellularity.