Urinary Casts and Disease Associations

Hyaline - May be nonspecific; seen in normal individuals or during severe intravascular volume depletion (after strenuous exercise or with diuretic use), first morning specimens, acidic and concentrated urine 

Granular - May be nonspecific, result from the breakdown of cellular casts "Muddy-brown" heme-granular casts are seen in acute tubular necrosis 

Waxy and broad - Advanced kidney disease 

Red blood cell - Glomerulonephritis 

White blood cell - Urinary tract infections (pyelonephritis, cystitis), tubulointerstitial nephritis, renal tuberculosis 

Fatty - Nephrotic syndrome ("Maltese cross" appearance under polarized light) 



Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ



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