Urinary cast

urinary castscastsRBC castsRed blood cell castscasts in urinegranular casthyaline castred blood cell casturinary sediment
Urinary casts are microscopic cylindrical structures produced by the kidney and present in the urine in certain disease states.wikipedia
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Tamm–Horsfall protein

Tamm-Horsfall proteinUMODuromodulin
They form via precipitation of Tamm–Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also by albumin in conditions of proteinuria.
It is the matrix of urinary casts derived from the secretion of renal tubular cells.

Acute tubular necrosis

tubular necrosisischemic kidney failurekidney injury
The "muddy brown cast" seen in acute tubular necrosis is a type of granular cast.
The presence of "muddy brown casts" of epithelial cells found in the urine during urinalysis is pathognomonic for ATN.

Kidney

kidneysrenalkidney disorder
Urinary casts are microscopic cylindrical structures produced by the kidney and present in the urine in certain disease states.
Microscopic analysis can also identify the presence of urinary casts and crystals.

Nephrotic syndrome

a serious kidney disorderGlomerulosclerosisidiopathic nephrotic syndrome
In nephrotic syndrome many additional types of cast exist including broad and waxy casts if the condition is chronic (this is referred to as a telescopic urine with the presence of many casts).
It is also examined for urinary casts, which are more a feature of active nephritis.

Rhabdomyolysis

muscle breakdownrapid muscle breakdownbreakdown of skeletal muscle
Pigments include those produced endogenously, such as hemoglobin in hemolytic anemia, myoglobin in rhabdomyolysis, and bilirubin in liver disease.
As the kidneys reabsorb more water from the filtrate, myoglobin interacts with Tamm–Horsfall protein in the nephron to form casts (solid aggregates) that obstruct the normal flow of fluid; the condition is worsened further by high levels of uric acid and acidification of the filtrate, which increase cast formation.

Granulomatosis with polyangiitis

Wegener's granulomatosiscoin lesion, pulmonary
The presence of red blood cells within the cast is always pathological, and is strongly indicative of granulomatosis with polyangiitis, systemic lupus erythematosus, post-streptococcal glomerulonephritis or Goodpasture's syndrome.

Systemic lupus erythematosus

lupusSLEsystemic lupus erythematosus (SLE)
The presence of red blood cells within the cast is always pathological, and is strongly indicative of granulomatosis with polyangiitis, systemic lupus erythematosus, post-streptococcal glomerulonephritis or Goodpasture's syndrome.

Urine

urinaryhuman urinepiss
Urinary casts are microscopic cylindrical structures produced by the kidney and present in the urine in certain disease states.

Distal convoluted tubule

distal tubuledistal convoluted tubulesdistal tubules
They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.

Collecting duct system

collecting ductcortical collecting ductcollecting ducts
They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.

Microscopy

light microscopymicroscopistmicroscopic
They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.

Mucoprotein

They form via precipitation of Tamm–Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also by albumin in conditions of proteinuria.

Nephron

renal tubulenephronsrenal tubules
They form via precipitation of Tamm–Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also by albumin in conditions of proteinuria. They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, where they can be detected by microscopy.

Albumin

albuminsalbuminousalbumin protein
They form via precipitation of Tamm–Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also by albumin in conditions of proteinuria.

Proteinuria

protein in the urineproteinIsolated proteinuria
They form via precipitation of Tamm–Horsfall mucoprotein which is secreted by renal tubule cells, and sometimes also by albumin in conditions of proteinuria.

PH

pH levelneutralpH value
Cast formation is pronounced in environments favoring protein denaturation and precipitation (low flow, concentrated salts, low pH).

Henry Bence Jones

Casts were first described by Henry Bence Jones (1813–1873).

Adjective

adjectivesadjectivalattributive adjective
"Cast" itself merely describes the shape, so an adjective is added to describe the composition of the cast.

Hemolytic anemia

haemolytic anaemiahemolytic anaemiahemolytic disease
Pigments include those produced endogenously, such as hemoglobin in hemolytic anemia, myoglobin in rhabdomyolysis, and bilirubin in liver disease.

Bilirubin

hyperbilirubinemiaconjugated bilirubinunconjugated bilirubin
Pigments include those produced endogenously, such as hemoglobin in hemolytic anemia, myoglobin in rhabdomyolysis, and bilirubin in liver disease.

Phenazopyridine

pyridiumPhenazopyridine hydrochlorideUristat
Drug pigments, such as phenazopyridine, may also cause cast discoloration.

Acute proliferative glomerulonephritis

post-streptococcal glomerulonephritispoststreptococcal glomerulonephritisPost-infectious glomerulonephritis
The presence of red blood cells within the cast is always pathological, and is strongly indicative of granulomatosis with polyangiitis, systemic lupus erythematosus, post-streptococcal glomerulonephritis or Goodpasture's syndrome.

Goodpasture syndrome

Goodpasture's syndromeanti-glomerular basement membrane diseaseAnti-Glomerular Basement Membrane nephritis
The presence of red blood cells within the cast is always pathological, and is strongly indicative of granulomatosis with polyangiitis, systemic lupus erythematosus, post-streptococcal glomerulonephritis or Goodpasture's syndrome.

Infarction

infarctinfarctedinfarcts
They can also be associated with renal infarction and subacute bacterial endocarditis.

Infective endocarditis

bacterial endocarditisinfectious endocarditisAcute infective endocarditis
They can also be associated with renal infarction and subacute bacterial endocarditis.