Information developed by A. Please discuss with your doctor any questions or concerns you may have. Medical Tests. Definition Urinary casts are tiny tube-shaped particles that can be found when urine is examined under the microscope during a test called urinalysis. Alternative Names Hyaline casts; Granular casts; Renal tubular epithelial casts; Waxy casts; Casts in the urine; Fatty casts; Red blood cell casts; White blood cell casts How the Test is Performed The urine sample you provide may need to be from your first morning urine.
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.
What Abnormal Results Mean Abnormal results may include: Fatty casts are seen in people who have lipids in urine. Bacteria are common in urine specimens because of the abundant normal microbial flora of the vagina or external urethral meatus and because of their ability to rapidly multiply in urine standing at room temperature. Therefore, microbial organisms found in all but the most scrupulously collected urines should be interpreted in view of clinical symptoms.
Diagnosis of bacteriuria in a case of suspected urinary tract infection requires culture. A colony count may also be done to see if significant numbers of bacteria are present. Multiple organisms reflect contamination.
However, the presence of any organism in catheterized or suprapubic tap specimens should be considered significant. Yeast cells may be contaminants or represent a true yeast infection. They are often difficult to distinguish from red cells and amorphous crystals but are distinguished by their tendency to bud.
Most often they are Candida, which may colonize bladder, urethra, or vagina. Common crystals seen even in healthy patients include calcium oxalate, triple phosphate crystals and amorphous phosphates.
Very uncommon crystals include: cystine crystals in urine of neonates with congenital cystinuria or severe liver disease, tyrosine crystals with congenital tyrosinosis or marked liver impairment, or leucine crystals in patients with severe liver disease or with maple syrup urine disease. General "crud" or unidentifiable objects may find their way into a specimen, particularly those that patients bring from home.
Spermatozoa can sometimes be seen. Rarely, pinworm ova may contaminate the urine. In Egypt, ova from bladder infestations with schistosomiasis may be seen. Random collection taken at any time of day with no precautions regarding contamination.
The sample may be dilute, isotonic, or hypertonic and may contain white cells, bacteria, and squamous epithelium as contaminants. In females, the specimen may cont contain vaginal contaminants such as trichomonads, yeast, and during menses, red cells. Early morning collection of the sample before ingestion of any fluid. This is usually hypertonic and reflects the ability of the kidney to concentrate urine during dehydration which occurs overnight.
If all fluid ingestion has been avoided since 6 p. Clean-catch, midstream urine specimen collected after cleansing the external urethral meatus.
A cotton sponge soaked with benzalkonium hydrochloride is useful and non-irritating for this purpose. A midstream urine is one in which the first half of the bladder urine is discarded and the collection vessel is introduced into the urinary stream to catch the last half. The first half of the stream serves to flush contaminating cells and microbes from the outer urethra prior to collection.
This sounds easy, but it isn't try it yourself before criticizing the patient. Catherization of the bladder through the urethra for urine collection is carried out only in special circumstances, i. This procedure risks introducing infection and traumatizing the urethra and bladder, thus producing iatrogenic infection or hematuria.
Suprapubic transabdominal needle aspiration of the bladder. When done under ideal conditions, this provides the purest sampling of bladder urine. This is a good method for infants and small children. To summarize, a properly collected clean-catch, midstream urine after cleansing of the urethral meatus is adequate for complete urinalysis.
In fact, these specimens generally suffice even for urine culture. Another important factor is the interval of time which elapses from collection to examination in the laboratory. Changes which occur with time after collection include: 1 decreased clarity due to crystallization of solutes, 2 rising pH, 3 loss of ketone bodies, 4 loss of bilirubin, 5 dissolution of cells and casts, and 6 overgrowth of contaminating microorganisms. Therefore, get the urine to the laboratory as quickly as possible.
Specific Gravity sp gr Specific gravity of urine is determined by the presence of solutes represented by particles of varying sizes, from small ions to larger proteins. Chronic kidney disease is the slow loss of kidney function over time.
The main job of the kidneys is to remove wastes and excess water from the body Fogazzi GB, Garigali G. Comprehensive Clinical Nephrology. Philadelphia, PA: Elsevier Saunders; chap 4. Evaluation of the urologic patient: history, physical examination, and urinalysis. Campbell-Walsh Urology. Philadelphia, PA: Elsevier Saunders; chap 3. Basic examination of urine.
Philadelphia, PA: Elsevier Saunders; chap The urinary system is made up of the kidneys, ureters, urethra and bladder. Reviewed By: Laura J. Editorial team. Doctors St. E-mail Form. Urinary casts Hyaline casts; Granular casts; Renal tubular epithelial casts; Waxy casts; Casts in the urine; Fatty casts; Red blood cell casts; White blood cell casts. Urinalysis Urinalysis is the physical, chemical, and microscopic examination of urine. Videos Figures Images Quizzes Symptoms. Courtesy of.
Urinary Casts. Urinary Casts Type. Glycoprotein matrix consisting mainly of Tamm-Horsfall protein secreted by tubules. Suggests pyelonephritis but can indicate other causes of tubulointerstitial inflammation. Occasionally occurs after exercise or dehydration when renal function is normal.
Clumped urates, WBCs, bacteria, hair, glass fragments, cloth fiber, or artifacts.
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