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 is normal hyaline casts?
Casts: Casts are formed in the tubules of they kidney when the tubules secrete a protein called Tamm-Horsfall protein. The origin of the casts causes them to take on a tubular or hotdog-like shape. These casts are known as hyaline casts and can be present in normal adults on the order of 0-5 per LPF.
What do hyaline casts in urine indicate?
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.
What do hyaline casts mean in 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 are casts in urine made of?
They form via precipitation of Tamm–Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also by albumin in conditions of proteinuria. Cast formation is pronounced in environments favoring protein denaturation and precipitation (low flow, concentrated salts, low pH).
How do you lower hyaline casts?
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). Hyaline casts are far easier to visualize using phase contrast microscopy, but this is not available on standard microscopes.
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