Циліндри сечі
Type | Description | Significance |
|---|---|---|
Plain casts | ||
Hyaline | Glycoprotein matrix consisting mainly of Tamm-Horsfall protein secreted by tubules | Nonspecific Can be present in normal urine or in patients with low urine flow (eg, due to dehydration, after diuretic therapy), physiologic stress, an acute renal disorder plus other abnormalities, or a chronic renal disorder (as broad casts formed in dilated tubules) |
Waxy | Glycoprotein matrix with degraded protein Formed in atrophic tubules Highly refractile with waxy appearance | Present in advanced chronic kidney disease |
Casts with inclusions | ||
RBC | Glycoprotein matrix with RBCs Often appears red-orange | Virtually pathognomonic of glomerulonephritis Occurs extremely rarely in patients with cortical necrosis or acute tubular injury or in runners with hematuria |
Epithelial cell | Protein matrix variably filled with tubular cells | Occurs in acute tubular injury, glomerulonephritis, or nephrotic syndrome |
WBC | Protein matrix variably filled with WBCs | Suggests pyelonephritis but can indicate other causes of tubulointerstitial inflammation May occur in proliferative glomerulonephritis |
Granular | Glycoprotein matrix with protein or cellular debris Often appears "muddy brown" | Occasionally occurs after exercise or dehydration when renal function is normal More often indicates acute tubular necrosis |
Pigment | Tubular cell or granular casts with pigment stain | Usually occurs in acute kidney injury due to hemolysis or rhabdomyolysis or in acute tubular necrosis |
Fatty | Fat droplets or oval fat bodies (cholesterol produces a Maltese cross pattern in polarized light) | May occur in various types of tubulointerstitial disorders In large numbers, strongly suggests nephrotic syndrome |
Mixed | Hyaline cast with various cells (eg, RBCs, WBCs, tubular cells) | Usually occurs in proliferative glomerulonephritis |
Pseudocasts | ||
— | Clumped urates, WBCs, bacteria, hair, glass fragments, cloth fiber, or artifacts | Important not to confuse with true casts, which are cylindrical and shaped like renal tubules |
RBCs = red blood cells; WBCs = white blood cells. | ||