Urinary Casts Test – Indications, Procedures, Results

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

Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called a urinalysis.

Urinary casts may be made up of white blood cells, red blood cells, kidney cells, or substances such as protein or fat. The content of a cast can help tell your health care provider whether your kidney is healthy or abnormal.

How the Test is Performed

The urine sample you provide may need to be from your first-morning urine. The sample needs to be taken to the lab within 1 hour.

A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate.

How to Prepare for the Test

No special preparation is needed.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Your provider may order this test to see if your kidneys are working properly. It may also be ordered to check for certain conditions, such as:

  • Glomerular disease
  • Interstitial kidney disease
  • Kidney infections

Normal Results

The absence of cellular casts or presence of a few hyaline casts is normal. The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results may include:

  • Fatty casts are seen in people who have lipids in urine. This is most often a complication of nephrotic syndrome.
  • Granular casts are a sign of many types of kidney diseases.
  • Red blood cell casts mean there is a microscopic amount of bleeding from the kidney. They are seen in many kidney diseases.
  • Renal tubular epithelial cell casts reflect damage to tubule cells in the kidney. These casts are seen in conditions such as renal tubular necrosis, viral disease (such as CMV nephritis ), and kidney transplant rejection.
  • Waxy casts can be found in people with advanced kidney disease and chronic kidney failure.
  • White blood cell (WBC) casts are more common with acute kidney infections.

Your provider will tell you more about your results.

Risks

There are no risks with this test.

FAQ

How do they test for casts in urine?

  • Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called a urinalysis. Urinary casts may be made up of white blood cells, red blood cells, kidney cells, or substances such as protein or fat.

What does it mean to have a cast in your urine?

  • They may be considered to represent a biopsy of the kidney. If a cast is seen in the urine, kidney disease or in-involvement exists; the presence of casts indicates kidney (renal) disease rather than lower urinary tract disease.

Are casts in urine normal?

  • 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 are casts?

  • Casts and splints are orthopedic devices that are used to protect and support fractured or injured bones and joints. They help to immobilize the injured limb to keep the bone in place until it fully heals. Casts are often made from fiberglass or plaster.

Why urine become turbid on standing?

  • Turbidity or cloudiness may be caused by excessive cellular material or protein in the urine or may develop from crystallization or precipitation of salts upon standing at room temperature or in the refrigerator.

Why are there fatty casts in nephrotic syndrome?

  • By use of a polarizing microscope, one can see oval fat bodies and also fatty casts. These point to the nephrotic syndrome. They occur because of glomerular filtration of lipoproteins; the tubular cells that endocytose these lipoproteins then fall off into the urine.

Where are casts formed?

  • Casts are cylindrical bodies formed either in the distal convoluted tubules or the collecting ducts of the kidney.

What types of casts are there?

Types of casts

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