Cytodiagnostic urinalysis is performed by examining Papanicolaou-stained cytocentrifuge preparations of urine sediment. Nonrenal transplant patient results (N = 1,602) were reviewed. Renal hematuria was found in 37.7% of specimens, white blood cell casts in 11%, and renal tubule cell injury in 53%. The technique demonstrates significantly improved sensitivity to detect urine sediment abnormalities indicative of renal parenchymal disease. The technical requirements are readily available and easy to implement in the laboratory. Skills required for identification and quantitation can be acquired in a few weeks.