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The most common type of cast, hyaline casts are solidified Tamm–Horsfall mucoprotein secreted from the tubular epithelial cells of individual nephrons. Low urine flow, concentrated urine, or an acidic environment can contribute to the formation of hyaline casts, and as such, they may be seen in normal individuals in dehydration or vigorous exercise.
"Hypertensive" refers to high blood pressure and "nephropathy" means damage to the kidney; hence this condition is where chronic high blood pressure causes damages to kidney tissue; this includes the small blood vessels, glomeruli, kidney tubules and interstitial tissues. The tissue hardens and thickens which is known as nephrosclerosis. [2]
Acute tubular necrosis is classified as a "renal" (i.e. not pre-renal or post-renal) cause of acute kidney injury. Diagnosis is made by a FENa (fractional excretion of sodium) > 3% and presence of muddy casts (a type of granular cast) in urinalysis.
Hyaline casts contain only protein and can be found in low numbers in healthy people; their numbers may increase transiently after exercise or dehydration. Persistently increased numbers are seen in many renal diseases. [113] They are almost transparent and can be difficult to see using light microscopy. [114]
Glitter cells (also called Sternheimer-Malbin positive cells) are polymorphonuclear leukocyte neutrophils with granules that show a Brownian movement and that are found in the urine, most commonly associated with urinary tract infections or pyelonephritis and especially prevalent under conditions of hypotonic urine (samples with specific gravity less than 1.01). [1]
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Myeloma cast nephropathy, also referred to as light-chain cast nephropathy, is the formation of plugs (urinary casts) in the kidney tubules from free immunoglobulin light chains leading to kidney failure in the context of multiple myeloma. It is the most common cause of kidney injury in myeloma.
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