Pigmented "muddy brown" granular cast is characteristic of: (A) Prerenal ARF, (B) Ischemic or nephrotoxic ATN, (C) Postrenal ARF, (D) Chronic renal failure
Answer is B. AKI from ATN due to ischemic injury, sepsis, or ceain nephrotoxins has characteristic urine sediment findings: pigmented "muddy brown" granular casts and tubular epithelial cell casts. These findings may be absent in more than 20% of cases Ref: Harrison 19e pg: 1805