Lecture Note: Significance of Specific Urinary Casts

Casts are composed of Tamm-Horsfall urinary mucoprotein in the shape of the nephron segment where they were formed.

Hyaline casts 
  • Concentrated urine, 
  • febrile disease, 
  • after strenuous exercise, 
  • in the course of diuretic therapy (not indicative of renal disease)

Red cell casts 
  • Glomerulonephritis 

White cell casts 
  • Pyelonephritis, 
  • interstitial nephritis (indicative of infection or inflammation)

Renal tubular cell casts 
  • Acute tubular necrosis, 
  • interstitial nephritis 

Coarse, granular casts 
Nonspecific; can represent acute tubular necrosis.
Broad, waxy casts 
  • Chronic kidney disease (indicative of stasis in enlarged collecting tubules). 


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