Urinary Cast

Aka: Urinary Cast, Urine Cast, Cellular Cast, Granular Cast, Hyaline Cast, Red Blood Cell Cast, RBC Cast, White Blood Cell Cast, WBC Cast, Fatty Cast

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II. Types: Glomerulus

  1. Red Blood Cell Casts (erythrocyte casts)
    1. Glomerulonephritis (dysmorphic RBCs)
    2. May be normal in Collision Sport athletes
  2. Fatty Casts (fat laden renal tubule cells)
    1. Nephrotic Syndrome
    2. Hypothyroidism

III. Types: Interstitium or Renal Tubules

  1. Epithelial cell casts
    1. Acute Tubular Necrosis
    2. Interstitial Nephritis
    3. Nephritic Syndrome
    4. Eclampsia
    5. Heavy Metal Poisoning
    6. Rejected Renal Transplant
  2. Granular Casts (renal tubule)
    1. Protein casts
    2. Cellular Cast breakdown (suggests severe renal disease)
      1. Acute Tubular Necrosis
      2. Acute Interstitial Nephritis
      3. Thrombotic Microangiopathy
  3. Waxy casts
    1. Severe, advanced renal disease
  4. White Blood Cell Casts (including Eosinophil casts)
    1. Pyelonephritis
    2. Glomerulonephritis
    3. Interstitial Nephritis (esoinophil casts)

IV. Types: Extrinsic Conditions

  1. Hyaline or mucoprotein casts
    1. Normal finding
    2. Pyelonephritis
    3. Chronic renal disease
    4. Prerenal Failure or Postrenal Failure

V. References

  1. Hitzeman (2022) Am Fam Physician 106(1): 27-35 [PubMed]
  2. Simerville (2005) Am Fam Physician 71(6): 1153-62 [PubMed]

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