Table of ContentsView AllTable of ContentsWhy they OccurUrinalysis ResultsUnderstanding the ResultsNext Steps
Table of ContentsView All
View All
Table of Contents
Why they Occur
Urinalysis Results
Understanding the Results
Next Steps
Urine casts result from protein or other materials that conform to the shape of the distal tubules of the kidneys and then get excreted in the urine. They are seen using a microscope’s low power field (LPF) during a urine examination (urinalysis) and often indicate kidney disease. Hyaline casts result from a specific protein called “uromodulin.”
Sometimes, hyaline casts result from dehydration or strenuous exercise and do not require further testing. Higher than normal hyaline cast levels may prompt additional laboratory and imaging tests to determine if the hyaline casts are due to kidney disease.
This article will help you understand the difference between “normal” and “high” hyaline cast ranges on a urinalysis and what each means for your health.
Rodolfo Parulan Jr. / Getty Images
The Anatomy of the Kidneys
Why Are Hyaline Casts in Urine?
Casts are created in the kidney’s distal tubules, or collecting ducts, where granular or waxy substances called proteins build up.Often, urine casts can indicate possible kidney disease.
Dehydration,diureticuse, or strenuous exercise are possible reasons for hyaline casts when there is no evidence of kidney disease.
Physiological Causes
Hyaline casts are often seen in a urinalysis test as a result of slow or sluggish urinary flow due to:
When Is Mucus in Urine Normal and Abnormal?
Pathological Causes
If the number of hyaline casts seen under a microscope’s low power field (LPF) in a urinalysis test is higher than two hyaline casts, a healthcare provider may perform additional testing for the following conditions:
Hyaline Cast Results From Urinalysis
The identification of casts in a urinalysis may pose concerning evidence of disease. However, hyaline casts are slightly different because they do not always indicate kidney disease. Generally, zero to two hyaline casts in LPF are not cause for concern.
Types of Urinary CastsUrinary casts are divided into two categories, acellular and cellular:Acellular casts are composed of proteins or fats and include hyaline casts, granular casts, waxy casts, and fatty casts.Cellular casts are composed of different types of cells, such as red or white blood cells. Cellular casts include red blood cell casts, white blood cell casts, bacterial cell casts, and renal tubule cells.
Types of Urinary Casts
Urinary casts are divided into two categories, acellular and cellular:Acellular casts are composed of proteins or fats and include hyaline casts, granular casts, waxy casts, and fatty casts.Cellular casts are composed of different types of cells, such as red or white blood cells. Cellular casts include red blood cell casts, white blood cell casts, bacterial cell casts, and renal tubule cells.
Urinary casts are divided into two categories, acellular and cellular:
Normal Range of Hyaline Casts
Hyaline casts are seen under a microscope’s LPF. Generally, zero to two hyaline casts/LPF is considered a normal range.A healthcare provider will typically determine whether you need further testing regarding the presence of hyaline casts based on your health history and status.
High Range of Hyaline Casts
Generally, casts are indicative of possible kidney disease. However, hyaline casts are slightly different and can be seen with any possible kidney disease.If more than two hyaline casts/LPF are identified, your healthcare provider should perform more testing to ensure there is no evidence of kidney disease.
Interpreting Results: What Do High Hyaline Casts Mean?
Hyaline casts can be seen in a microscopic urinalysis test. Generally, a normal amount of hyaline casts is 0–2/LPF. If more than two hyaline casts/LPF are identified in a microscopic urinalysis exam, it could indicate the possibility of kidney disease. Some conditions that could cause high levels of hyaline casts include:
Next Steps With Above Average Hyaline Urine Casts
If more than two hyaline casts/LPF are identified in a microscopic urinalysis exam, a healthcare provider may order further testing to determine if you are at risk for kidney disease. Testing might include:
Summary
Hyaline casts are a specific type of sediment found in urine. Often, urinary casts can help identify kidney disease processes. Hyaline casts, however, do not always indicate a kidney disease process. It is possible for a urine sample to have a small number of hyaline casts present in the absence of any kidney disease. If the hyaline cast count is greater than two/LPF, it could indicate kidney or heart disease. For such cases, a healthcare provider will likely order additional testing.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shikata E, Hattori R, Hara M, Nakayama T.The detection of hyaline casts in patients without renal dysfunction suggests increased plasma BNP.EJIFCC. 2021;32(4):410-420.LabCE.Formation and significance of casts.Cavanaugh C, Perazella MA.Urine sediment examination in the diagnosis and management of kidney disease: core curriculum 2019.American Journal of Kidney Diseases. 2019;73(2):258-272. doi.org/10.1053/j.ajkd.2018.07.012Devuyst O, Olinger E, Rampoldi L.Uromodulin: from physiology to rare and complex kidney disorders.Nat Rev Nephrol13, 525–544 (2017). https://doi.org/10.1038/nrneph.2017.101/National Library of Medicine.Urinalysis.Osmosis from Elsevier.Hyaline casts: what are they, causes, diagnosis, treatment, and more.National Institute of Diabetes and Digestive and Kidney Diseases.Glomerular disease.National Institute of Diabetes and Digestive and Kidney Diseases.Pyelonephritis.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shikata E, Hattori R, Hara M, Nakayama T.The detection of hyaline casts in patients without renal dysfunction suggests increased plasma BNP.EJIFCC. 2021;32(4):410-420.LabCE.Formation and significance of casts.Cavanaugh C, Perazella MA.Urine sediment examination in the diagnosis and management of kidney disease: core curriculum 2019.American Journal of Kidney Diseases. 2019;73(2):258-272. doi.org/10.1053/j.ajkd.2018.07.012Devuyst O, Olinger E, Rampoldi L.Uromodulin: from physiology to rare and complex kidney disorders.Nat Rev Nephrol13, 525–544 (2017). https://doi.org/10.1038/nrneph.2017.101/National Library of Medicine.Urinalysis.Osmosis from Elsevier.Hyaline casts: what are they, causes, diagnosis, treatment, and more.National Institute of Diabetes and Digestive and Kidney Diseases.Glomerular disease.National Institute of Diabetes and Digestive and Kidney Diseases.Pyelonephritis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shikata E, Hattori R, Hara M, Nakayama T.The detection of hyaline casts in patients without renal dysfunction suggests increased plasma BNP.EJIFCC. 2021;32(4):410-420.LabCE.Formation and significance of casts.Cavanaugh C, Perazella MA.Urine sediment examination in the diagnosis and management of kidney disease: core curriculum 2019.American Journal of Kidney Diseases. 2019;73(2):258-272. doi.org/10.1053/j.ajkd.2018.07.012Devuyst O, Olinger E, Rampoldi L.Uromodulin: from physiology to rare and complex kidney disorders.Nat Rev Nephrol13, 525–544 (2017). https://doi.org/10.1038/nrneph.2017.101/National Library of Medicine.Urinalysis.Osmosis from Elsevier.Hyaline casts: what are they, causes, diagnosis, treatment, and more.National Institute of Diabetes and Digestive and Kidney Diseases.Glomerular disease.National Institute of Diabetes and Digestive and Kidney Diseases.Pyelonephritis.
Shikata E, Hattori R, Hara M, Nakayama T.The detection of hyaline casts in patients without renal dysfunction suggests increased plasma BNP.EJIFCC. 2021;32(4):410-420.
LabCE.Formation and significance of casts.
Cavanaugh C, Perazella MA.Urine sediment examination in the diagnosis and management of kidney disease: core curriculum 2019.American Journal of Kidney Diseases. 2019;73(2):258-272. doi.org/10.1053/j.ajkd.2018.07.012
Devuyst O, Olinger E, Rampoldi L.Uromodulin: from physiology to rare and complex kidney disorders.Nat Rev Nephrol13, 525–544 (2017). https://doi.org/10.1038/nrneph.2017.101/
National Library of Medicine.Urinalysis.
Osmosis from Elsevier.Hyaline casts: what are they, causes, diagnosis, treatment, and more.
National Institute of Diabetes and Digestive and Kidney Diseases.Glomerular disease.
National Institute of Diabetes and Digestive and Kidney Diseases.Pyelonephritis.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.Cookies SettingsAccept All Cookies
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
Cookies SettingsAccept All Cookies
