Urine Casts: Definition and Development (Nursing)

by Rhonda Lawes

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    00:00 Hi, welcome to our video series on interpreting lab values.

    00:05 In this portion of the series, we're going to look at a urinalysis microscopic exam, but we're looking specifically at urine casts.

    00:13 Now keep in mind, cast in the urine indicate kidney disease versus a lower urinary tract disease.

    00:20 So we pay really close attention to these.

    00:23 Before I go on, I want to make sure you are crystal clear on that.

    00:30 Cast in the urine indicate we've got a kidney problem.

    00:34 It's not a lower urinary tract problem, it's definitely a kidney problem.

    00:38 Here's why.

    00:39 Casts are formed in the lumen of the nephron of the kidneys, and then they are excreted in the urine.

    00:46 That's why we know we got a kidney problem because casts are formed in the specific anatomy of the kidney.

    00:53 Now they're made up of these hardened proteins and other cells.

    00:58 So identifying the other cells can give us really important information about the conditions in the nephron.

    01:05 Okay, I don't want to go on until we're really clear on what this content is.

    01:10 Casts, tell me I've got a kidney problem like right in the kidney? Why? Because cast are formed in the lumen.

    01:18 And we say lumen, that's the opening of the tube in the nephron, right? So that's why they're shaped kind of like a tube.

    01:26 What are they made up of? A hardman protein plus other cells.

    01:31 So cast usually have a hardman protien, and other cells.

    01:36 So it's those other cells, if we can identify them, they can give us really important information about specific conditions in the nephron.

    01:46 So who's most likely to develop a cast? So what type of patients or what things are going on in their body that make them most likely to develop cast? Low renal flow is one of them.

    01:59 Now let's think about that.

    02:00 Cast, are heart and protein.

    02:03 Think of them as kind of a mold, and then these other cells get in there.

    02:07 So how would low flow make that a problem? Well, if I'm going to make a mold, I would like things to be moving through very slowly, right? If things are whipping through that kidney, you're not likely to have many casts developed.

    02:21 What about high salt concentration? Yeah, this helps make an environment that's really friendly, the cast being developed.

    02:29 The third piece is low or acidic pH.

    02:34 So if a patient has casts, they likely have low renal flow, meaning they've got some kidney damage, probably a high salt concentration, and a low or acidic pH.

    About the Lecture

    The lecture Urine Casts: Definition and Development (Nursing) by Rhonda Lawes is from the course Interpretation of Renal Lab Values (Nursing).

    Author of lecture Urine Casts: Definition and Development (Nursing)

     Rhonda Lawes

    Rhonda Lawes

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