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This quote from Prof. Addis starts the magnificent historical introductory chapter of this third edition of the book ‘The Urinary Sediment: An Integrated View’ of Prof. Fogazzi. This book made me wonder how Dr Addis would be disappointed when he, being on call in one of our megahospitals, would find out that nowadays it is sometimes easier and often quicker to obtain a renal ultrasound or even a CT scan than to know the result of the urinary sediment, at least if the consultant is not doing this examination him/herself. Even more pertinent than the eventual disappointment of Dr Addis was my personal experience only a couple of weeks ago at an editorial meeting of a major textbook of nephrology where the question was seriously raised on whether in the textbook a separate chapter on urinary sediment should be included. One of the arguments against was that urinary sediments are nowadays very rarely done and that most clinical laboratories are now using automatic systems for this analysis, and that clinicians, including nephrologists, are only very rarely looking at the urine anymore. It is refreshing that in this book, not only the advantages but also the limitations of these automated systems for urinary sediment analysis are discussed in a separate chapter. It is a pity that despite this high-quality book with its numerous beautiful illustrations and photographs, not many clinicians are still fascinated by this clinical art. It is therefore admirable that Dr Fogazzi and his coauthors still had the courage to publish this third edition, 10 years after the previous edition. The book contains, besides the historical chapter and a more technical appendix, eight chapters covering virtually all aspects of the examination of the urinary sediment. The introductory chapters describe the formed elements of the sediment, the impact of drugs and the sediment in the normal subject. For the clinician, the most relevant chapters are those where the urinary sediment is described in the most frequent individual diseases of the kidney and the urinary tract. I was pleasantly surprised that attention was also paid to the diagnostic value of the urinary sediment in the patient suspected of suffering from acute kidney injury, notably acute tubular necrosis. Even very recent papers [1,2] have shown that the diagnostic and prognostic yield of a carefully performed urine microscopy by using a simple scoring systemwas at least as powerful as manymore sophisticated and obviously much more expensive biological tests. The coloured pictures are of excellent quality, and many diagnostic tables are supplementing the clear and concise text. A new chapter on quality control programmes for urinary sediment analysis has been added in third edition. This book, despite the somewhat pessimistic reflections above, deserves to be widely distributed in all renal units.

The Urinary Sediment, 3rd edition, 2010, Giovanni B. Fogazzi, Elsevier, Milano; pp. 254