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Urinary casts
Hyaline casts; Granular casts; Renal tubular epithelial casts; Waxy casts; Casts in the urine; Fatty casts; Red blood cell casts; White blood cell casts
Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called urinalysis .
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
Urinary casts may be made up of white blood cells, red blood cells, kidney cells, or substances such as protein or fat. The content of a cast can help tell your health care provider whether your kidney is healthy or abnormal.
How the Test is Performed
The urine sample you provide may need to be from your first morning urine. The sample needs to be taken to the lab within 1 hour.
A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.
Clean-catch urine sample
A clean catch is a method of collecting a urine sample to be tested. The clean-catch urine method is used to prevent germs from the penis or vagina ...
How to Prepare for the Test
No special preparation is needed.
How the Test will Feel
The test involves only normal urination. There is no discomfort.
Why the Test is Performed
Your provider may order this test to see if your kidneys are working properly. It may also be ordered to check for certain conditions, such as:
-
Glomerular disease
Glomerular disease
Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged....
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Interstitial kidney disease
Interstitial kidney disease
Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become swollen (inflamed). This can cause problems with t...
ImageRead Article Now Book Mark Article - Kidney infections
Normal Results
The absence of cellular casts or presence of a few hyaline casts is normal. The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
What Abnormal Results Mean
Abnormal results may include:
-
Fatty casts are seen in people who have lipids in urine. This is most often a complication of
nephrotic syndrome
.
Nephrotic syndrome
Nephrotic syndrome is a group of symptoms that include protein in the urine, low blood protein levels in the blood, high cholesterol levels, high tri...
ImageRead Article Now Book Mark Article - Granular casts are a sign of many types of kidney diseases.
- Red blood cell casts mean there is a microscopic amount of bleeding from the kidney. They are seen in many kidney diseases.
-
Renal tubular epithelial cell casts reflect damage to tubule cells in the kidney. These casts are seen in conditions such as
renal tubular necrosis
, viral disease (such as
CMV nephritis
), and kidney
transplant rejection
.
Renal tubular necrosis
Acute tubular necrosis is a kidney disorder involving damage to the tubule cells of the kidneys, which can lead to acute kidney failure.
ImageRead Article Now Book Mark ArticleCMV nephritis
Cytomegalovirus (CMV) infection is a disease caused by a type of herpes virus.
ImageRead Article Now Book Mark ArticleTransplant rejection
Transplant rejection is a process in which a transplant recipient's immune system attacks the transplanted organ or tissue.
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Waxy casts can be found in people with advanced kidney disease and
chronic kidney failure
.
Chronic kidney failure
Chronic kidney disease is the slow loss of kidney function over time. The main job of the kidneys is to remove wastes and excess water from the body...
ImageRead Article Now Book Mark Article - White blood cell (WBC) casts are more common with acute kidney infections.
Your provider will tell you more about your results.
Risks
There are no risks with this test.
References
Fogazzi GB, Garigali G. Urinalysis. In: Johnson RJ, Feehally J, Floege J, eds. Comprehensive Clinical Nephrology . 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 4.
Gerber GS, Brendler CB. Evaluation of the urologic patient: history, physical examination, and urinalysis. In: Wein AJ, Kavoussi LR, Novick AC, et al, eds. Campbell-Walsh Urology . 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 3.
McPherson RA, Ben-Ezra J. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 28.
Review Date: 8/29/2015
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
