Thursday, February, 09, 2012

Urinary casts

Table of Contents

Alternative Names

Hyaline casts; Granular casts; Renal tubular epithelial casts; Waxy casts; Casts in the urine; Fatty casts; Red blood cell casts; White blood cell casts


Normal Values

There are different types of casts. The presence of a few hyaline casts is normal.


What abnormal results mean

Abnormal results may include:

  • Fatty casts are seen in people who have lipids in urine, usually as a complication of nephrotic syndrome.
  • Granular casts are a sign of underlying kidney disease. However, they are nonspecific and may be found in people with many different kidney disorders.
  • Hyaline casts are usually caused by dehydration, exercise, or diuretic medicines.
  • Red blood cell casts are a sign of bleeding into the kidney tubule. They are seen in many diseases affecting the glomerulus, including IgA nephropathy, lupus nephritis, Goodpasture syndrome, and Wegener's granulomatosis.
  • Renal tubular epithelial cell casts reflect damage to the tubules. They are seen in renal tubular necrosis, viral disease (such as CMV nephritis), and transplant rejection.
  • Waxy casts are associated with advanced kidney disease and chronic kidney failure.
  • White blood cell (WBC) casts are more common in interstitial cell kidney diseases such as interstitial inflammation, pyelonephritis, and parenchymal infection.

This test may also show:

  • Acute nephritic syndrome
  • Glomerulonephritis - chronic
  • Glomerulonephritis - post-streptococcal
  • Glomerulonephritis - rapidly progressive
  • Complicated urinary tract infection
  • Necrotizing vasculitis
  • Rhabdomyolysis
  • Primary amyloid
  • Secondary amyloid
  • Systemic lupus erythematosus

Review Date: 08/07/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)