Urinary Casts and Disease Associations Hyaline - May be nonspecific; seen in normal individuals or during severe intravascular volume depletion (after strenuous exercise or with diuretic use), first morning specimens, acidic and concentrated urine Granular - May be nonspecific, result from the breakdown of cellular casts "Muddy-brown" heme-granular casts are seen in acute tubular necrosis Waxy and broad - Advanced kidney disease Red blood cell - Glomerulonephritis White blood cell - Urinary tract infections (pyelonephritis, cystitis), tubulointerstitial nephritis, renal tuberculosis Fatty - Nephrotic syndrome ("Maltese cross" appearance under polarized light) Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ #Urinary #Casts #Differential #Microscopy #Diagnosis #Nephrology