Page 40 - Clinical Biochemistry 08PB804

Hyaline casts
• They have a smooth texture and a refractive index very close to that of the surrounding
fluid.
• Greater numbers of hyaline casts may be seen associated with proteinuria of renal (eg.,
glomerular disease) or extra-renal (eg., as in myeloma; blood cancer) origin.

Figure 8: hyaline cast

Cellular casts
Most commonly result when disease processes such as ischemia, infarction or nephrotoxicity
cause degeneration and necrosis of tubular epithelial cells.
Waxy casts
• Have a smooth consistency but are more refractive and therefore easier to see compared to
hyaline casts.
• Waxy casts are found especially in chronic renal diseases, and are associated with chronic
renal failure; they occur in diabetic nephropathy, malignant hypertension and
glomerulonephritis.

Figure 9: waxy cast