Casts In Urine

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Hyaline Casts
- formed in absence of cells in tubular lumen
- smooth texture
- greater # of casts are associated with proteinuria
- can be found in normal urine after exercise, stress, or febrile disease

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Cellular Casts
- commonly seen with disease processes such as ischaemia, infarction, or nephrotoxicity
- causes degeneration and necrosis of tubular epithelial cells
- sometimes incorporate leukocytes

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Granular Casts
- usually formed as stage in degeneration of cellular casts
- textured appearance

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Fatty Casts
- identified by presence of refractile lipid droplets
- often seen in urine with lipid droplets
- character of matrix determines significance

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Waxy Casts
- squared-off ends
- indicate tubular injury