CASTS
Description
Normally very few or no casts are seen
Clinical significance
- Casts are cylindrical particles sometimes found in urine that are formed from coagulated protein released by kidney cells. They are formed in the tubules and usually take the shape of the tubule (hence the name). Normally, healthy people may have a few (0–5) hyaline casts per low power field (LPF). Hyaline casts are found in healthy individuals and are relatively nonspecific. They may be increased after strenuous exercise
- Other types of casts are associated with different kidney diseases, and the type of casts found in the urine may give clues as to which disorder is affecting the kidney
- Red cell casts are nearly diagnostic of glomerulonephritis or vasculitis
- White cell casts and pyuria are most commonly seen with tubule interstitial nephritis, acute pyelonephritis, renal tuberculosis and vaginal infections
- Muddy-brown granular casts are diagnostic of acute tubular necrosis
- Waxy and broadcasts are consistent with advanced renal failure
- Fatty casts and lipiduria, with the typical maltese-cross appearance on polarized microscopy, are commonly seen with nephrotic syndrome
When to get tested
- As part of a routine urine analysis
- Typically done when there are abnormal findings on the physical or chemical examination
Elevated level
- Glomerulonephritis
- Vasculitis
- Tubulointerstitial nephritis
- Acute pyelonephritis
- Renal tuberculosis
- Vaginal infections
- Acute tubular necrosis
- Nephrotic syndrome
Decreased level
Profile
Urine Analysis
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