Urine Casts: Definition and Development (Nursing)

by Prof. 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 protein, 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 hard 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 Prof. Lawes is from the course Interpretation of Renal Lab Values (Nursing).

    Included Quiz Questions

    1. Casts in the urine indicate kidney disease
    2. Casts are comprised of hardened proteins and other cells
    3. Low or acidic renal pH is a risk factor for developing urine casts
    4. Casts are formed from the lumen of the ureters
    5. High renal flow rate is a risk factor for developing urine casts

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

     Prof. Lawes

    Prof. Lawes

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