What Are Hyaline Casts In Urine?

Hyaline casts are simple urinary casts. These casts are microscopic; they can be cells, fat, bodies, or microorganisms, which may be wrapped in a protein matrix. A urinary cast is tube-like and can be examined under a microscope. This shows that you might have kidney problems or other body conditions. Sometimes, ordinary people without diseased conditions can develop temporary urinary casts, which may be due to dehydration. These casts can be detected by simple, non-invasive urine collection and urinalysis. These tests are completely safe and risk-free. Casts are formed in the Distal convoluted tubule (DCT) and collect kidney ducts. This causes the deposition of a protein named uromodulin, which is released by epithelial tubule cells. Urinary casts are of two types cellular casts and non-cellular casts. Hyaline casts are a type of non-cellular cast. We will learn in this article what are hyaline casts in urine, their causes, and their ideal range.

What are Hyaline casts in urine?

Hyaline casts can be found in healthy individuals and other individuals with kidney diseases. The presence of hyaline casts shows a decreased or sluggish urine flow, this can be a result of strenuous exercise, diuretic medications, severe vomiting, or fever. Large amounts of hyaline casts indicate kidney problems and must be consulted with a doctor.

What do hyaline casts in urine indicate?

Hyaline casts indicate kidney problems or infections such as pyelonephritis—chronic diseases like kidney damage from high blood pressure and lupus. Kidney damage can also be from diabetes as per the condition of diabetes nephropathy.

The presence of some hyaline casts is regular. These are the most common types of urinary casts. They’re made up of a protein called uromodulin and are usually caused by dehydration, strenuous exercise, and kidney failure.

Abnormal amounts of hyaline casts can indicate problems like Nephrotic syndrome or conditions such as cytomegalovirus (CMV) nephritis and kidney transplant rejection. Your Healthcare provider will tell you more about your results and what they indicate, so it is important to consult them.

What are the causes of hyaline casts in urine?

Hyaline casts in urine can be due to some causes, which are mentioned below:

  • Dehydration, use of diuretics, or physical exercise are possible reasons for hyaline casts.
  • Physiological problems can also be a significant cause of hyaline casts.
  • Slow urinary flow due to kidney diseases can cause a hyaline cast.
  • Kidney infection can cause hyaline casts.
  • Congestive heart failure can lead to hyaline casts.
  • Kidney damage from diabetes (i.e., diabetic nephropathy) can result in hyaline casts.

What is the normal range of hyaline casts in urine?

Hyaline casts are seen under a microscope’s Low power field (LPF). Usually, the presence of casts in the urine is generally considered an unusual finding. However, small amounts of hyaline casts (between 0–2 casts per low power field of the microscope) may be detected in the urine of healthy individuals without necessarily indicating a severe condition like kidney disease. Your doctor will tell you whether you need more tests to detect hyaline casts based on your present status and history.

What is considered a high range of hyaline casts in urine?

As discussed, 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 2 hyaline casts/LPF are observed, your healthcare provider will recommend more tests to confirm kidney problems.

Diagnosis of Hyaline Casts in urine?

Hyaline casts are diagnosed by microscopy technique which is a part of a test called urine analysis.

  • This test is performed by centrifuging a urine sample so that the suspended particles in the urine (e.g. casts, cells, pathogenic microorganisms), also known as urine sediment, are separated from the fluid.
  • A small urine drop is then placed on a slide made of glass to be examined under the microscope.
  • Under the microscope, hyaline casts are shown as transparent, tiny particles.
  • They are easily missed and can’t be seen due to their low refractive index or the lack of contrast between the surrounding urine and the hyaline casts.

Prevention of hyaline casts in urine?

If hyaline casts are detected in patients with kidney damage, treatment may be necessary and will depend on the specific cause of decreased renal function. But few prevention options may involve

  • Avoiding Diuretic medications
  • Being hydrated with water and liquids
  • Addressing the cause of kidney damage early and consult the doctor immediately.
  • Regular medical checkups help identify underlying medical conditions before the formation of the high number of casts and their excretion in the urine.
  • Avoiding non-steroidal anti-inflammatory drugs can increase protein concentration, so minimizing it can lead to the prevention of the formation of casts.

What do the different types of urinary casts indicate in a test?

The type of urinary cast found in testing can indicate a condition that can help doctors confirm a diagnosis. Types of casts and the problem they indicate are as follows:

  • Hyaline casts: Dehydration or chronic kidney disease.
  • RBC casts: Inflammation of the kidney’s filters (glomerulonephritis)
  • WBC casts: Kidney inflammation or infection.
  • Bacterial casts: Infections.
  • Fatty casts: Too much protein in the urine (nephrotic syndrome), lupus, lipoid nephrosis.
  • Renal tubular epithelial casts: Damage to kidney tubes.
  • Granular casts: Urinary retention, urinary tract infections, chronic kidney disease.
  • Waxy casts: Urinary retention, advanced kidney disease.


Hyaline casts are simple urinary casts generally in the range of 0-2 in a healthy individual. These casts may be caused by doing heavy exercises, kidney infections, and congestive heart failure-like conditions. Simple and painless tests like urinalysis and microscopy diagnose these casts. More than 2 casts in urine can indicate abnormal kidney functions for which the prevention tips must be followed, and consult your doctor for proper treatment.

Frequently Asked Questions

Are crystals in urine serious?

Crystals coming in urine are called by the phenomenon of crystalluria. Some crystals don’t cause problems. But, some crystals can become big with time and so can block the kidney and tubules resulting in kidney stones leading to kidney disease or infection.

What Colour is healthy urine?

Normally, urine is pale yellow, but certain food items like beetroots, etc., can change the color of your urine. Also, some medications, like rifampicin etc, can cause a change in urine color to orange or greenish.

What additional factors contribute to the formation of casts in my urine?

The following factors might promote the formation of casts in the kidney:
Larger than average amounts of plasma proteins entering the tubules
Decreased pH
Decreased urinary flow rate
Increased urine concentration

What is the shape of a hyaline cast?

Usually, hyaline casts are tubule-like structures. The cast can be classified as cellular or granular if the material inside takes up to 1/3 of its volume.

What is the Color of hyaline?

Hyaline casts are pearl-gray in Color and have a firm consistency with a large amount of collagen.

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