What do urinary casts indicate?
Urinary casts are microscopic clusters of urinary particles, such as cells, fat bodies, or microorganisms, wrapped in a protein matrix and found in the urine. Urinary casts serve as clinical indicators of kidney condition and can be assessed to determine the functioning of the kidneys.
Is it normal to have casts in urine?
Very few casts are seen in the urine of a person without renal disease. A common exception is hyaline casts, which may often be seen in healthy patients or can be present after strenuous exercise or diuretic use. A significant number of urinary casts usually indicates the presence of renal disease.
What causes casts to form in urine?
Casts are the result of solidification of material (protein) in the lumen of the kidney tubules, more specifically in the nephron. Once formed, these molds (or casts) of the tubule are eliminated via the urine and may be seen in the urine sedi- ment.
How many casts in urine is normal?
Hyaline casts are the most frequently observed, and zero to two casts per low-power field is considered normal. Increased urine concentration, such as from dehydration, and elevated albumin concentration also affect the emergence of hyaline urine casts11.
What type of cast is most commonly found in urine?
The most common type of cast, hyaline casts are solidified Tamm–Horsfall mucoprotein secreted from the tubular epithelial cells of individual nephrons.
Where are urinary casts formed?
Thus, narrow casts are formed in the distal tubules while broad casts are formed in the collecting ducts. The matrix of all casts is thought to be Tamm-Horsfall protein, a glycoprotein secreted by the distal loop of Henle and the distal tubule.
What conditions favor the casts to be formed?
The factors that favor protein cast formation are low flow rate, high salt concentration, and low pH because these conditions favor protein precipitation. A few hyaline casts are normal, but all other casts need to be evaluated.
How is cast formed?
With renal tubular injury, epithelial cells slough into the lumen of the renal tubules and are caught up within a mucoprotein matrix made from Tamm-Horsfall protein (hyaline cast). This forms a cellular cast.
What does it mean if you have hyaline casts in your urine?
Casts are clusters of urinary sediment elements (red blood cells, white blood cells, fat bodies, etc.) wrapped in a protein matrix. Cast formation necessarily occurs in the kidney tubules, and the the contents of the casts indicate the nature of the abnormalities occurring in the kidney itself.
What diseases can be diagnosed by testing urine?
Healthcare providers often use urinalysis to screen for or monitor certain common health conditions, such as liver disease, kidney disease and diabetes, and to diagnose urinary tract infections (UTIs).
Are my kidneys infected?
Symptoms of a kidney infection often come on within a few hours. You can feel feverish, shivery, sick and have a pain in your back or side. In addition to feeling unwell like this, you may also have symptoms of a urinary tract infection (UTI) such as cystitis.
What are some examples of abnormal findings in a urinalysis?
Things the dipstick test can check for include:Acidity, or pH. If the acid is abnormal, you could have kidney stones, a urinary tract infection (UTI), or another condition.Protein. This can be a sign your kidneys aren't working right. ... Glucose. ... White blood cells. ... Nitrites. ... Bilirubin. ... Blood in your urine.
What does it mean if you have hyaline casts in your urine?
Casts are clusters of urinary sediment elements (red blood cells, white blood cells, fat bodies, etc.) wrapped in a protein matrix. Cast formation necessarily occurs in the kidney tubules, and the the contents of the casts indicate the nature of the abnormalities occurring in the kidney itself.
What conditions favor the casts to be formed?
The factors that favor protein cast formation are low flow rate, high salt concentration, and low pH because these conditions favor protein precipitation. A few hyaline casts are normal, but all other casts need to be evaluated.
What is considered an abnormal substance in urine?
Abnormal: Cloudy urine can be caused by pus (white blood cells), blood (red blood cells), sperm, bacteria, yeast, crystals, mucus, or a parasite infection, such as trichomoniasis. Abnormal: Some foods (such as asparagus), vitamins, and antibiotics (such as penicillin) can cause urine to have a different odor.
What is the clinical significance of broad casts in the urine sediment?
Broad casts or "renal failure' casts are associated with end-stage renal disease. They are formed in the collecting ducts as the result of urinary stasis and are two to six times the size of other types of casts. Any type of cast can be a broad cast.
What does it mean if your Hyaline Cast result is too high?from healthmatters.io
A few hyaline casts may occasionally be found in normal urine, and hyaline casts may be seen after strenuous exercise, during fever, or when undergoing diuretic therapy. Greater numbers of hyaline casts may be seen in association with proteinuria of prerenal (e.g., overflow proteinuria as in myeloma) or renal (e.g., glomerular disease) origin. In such cases it has been proposed that the presence of excessive serum protein in the tubular lumen promotes precipitation of the Tamm-Horsefall mucoprotein. Not all cases of proteinuria will have hyaline casts.
What do hyaline casts in urine indicate?from osmosis.org
The presence of hyaline casts typically indicates a decreased or sluggish urine flow, which can be a result of strenuous exercise, diuretic medications, severe vomiting, or fever. In combination with other clinical findings, large amounts of hyaline casts may indicate kidney damage due to decreased blood flow to the kidneys.
What causes hyaline casts?from osmosis.org
Hyaline casts are composed of aggregated Tamm-Horsfall protein in the tubular lumen of the kidney. Increased precipitation of Tamm-Horsfall protein can be caused by a variety of factors:
How are hyaline casts formed?from healthmatters.io
Hyaline casts are formed in the absence of cells in the tubular lumen. They consist of Tamm-Horsfall mucoprotein and have a smooth texture and a refractive index very close to that of the surrounding fluid. They are very difficult to see in wet preparations of urine and must be distinguished from mucus strands. Generally, hyaline casts have parallel sides with clear margins and blunted ends, whereas mucus strands are more variable in size with irregular margins. Reduced lighting is essential to see hyaline casts in urine sediment preparations. Lighting can be reduced by lowering the substage condenser (or close the iris diaphragm).
What is the Maltese cross?from en.wikipedia.org
They are pathognomonic for high urinary protein nephrotic syndrome.
What are the different types of casts in nephrotic syndrome?from en.wikipedia.org
In nephrotic syndrome many additional types of cast exist including broad and waxy casts if the condition is chronic (this is referred to as a telescopic urine with the presence of many casts).
Why are waxy casts larger than hyaline casts?from en.wikipedia.org
Additionally, due to urine stasis and their formation in diseased, dilated ducts, these casts are significantly larger than hyaline casts.
What does it mean if your Hyaline Cast result is too high?from healthmatters.io
A few hyaline casts may occasionally be found in normal urine, and hyaline casts may be seen after strenuous exercise, during fever, or when undergoing diuretic therapy. Greater numbers of hyaline casts may be seen in association with proteinuria of prerenal (e.g., overflow proteinuria as in myeloma) or renal (e.g., glomerular disease) origin. In such cases it has been proposed that the presence of excessive serum protein in the tubular lumen promotes precipitation of the Tamm-Horsefall mucoprotein. Not all cases of proteinuria will have hyaline casts.
What is the difference between hyaline and mucus?from healthmatters.io
Generally, hyaline casts have parallel sides with clear margins and blunted ends, whereas mucus strands are more variable in size with irregular margins.
What is a hyaline cast?from healthmatters.io
Hyaline casts are formed in the absence of cells in the tubular lumen. They consist of Tamm-Horsfall mucoprotein and have a smooth texture and a refractive index very close to that of the surrounding fluid. They are very difficult to see in wet preparations of urine and must be distinguished from mucus strands.
What is a cast in urine?from healthmatters.io
Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called urinalysis.
Can you see hyaline casts with a microscope?from healthmatters.io
Hyaline casts are far easier to visualize using phase contrast microscopy, but this is not available on standard microscopes. They become more visible with regular light microscopy if fat sticks to the protein matrix (Tamm-Horsfall mucoprotein) that makes up the hyaline cast (hyaline with fat) or particulate material from degenerating cells is present within the cast matrix (hyaline to finely granular cast). Note that when fat droplets stick to hyaline casts, they are still called hyaline and not fatty casts.
