Microscopic structures found in the urine that are composed of precipitated protein are called casts.
What is urine casting?
Urinary casts are cylindrical formations created by tubular cells secreting coagulated protein (Tamm-Horsfall protein).
- As the name implies, they are created and given shape in the long, thin, hollow renal tubules.
- They form in the collecting duct or the distal convoluted tubule. Cast formation does not occur in the proximal convoluted tubule or the loop of Henle.
- Low urine flow rate, high urinary salt concentration, and low urine pH all contribute to protein denaturation and precipitation of Tamm-Horsfall protein, the organic matrix that holds the casts together.
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