Urine Cast Types: Hyaline, Granular, Red Cell, White Cell, and Waxy Casts
The types of urine casts a urinalysis can report, what each one is made of, which can be a normal finding, and which kidney conditions each type is linked to.
- Published
- August 10, 2024
- Last updated
- November 2, 2026
- Read time
- 3 min read
- Medically reviewed by
-
Rhonda Collins, FNP-C
Urine cast type is the kind of cast seen on the microscopic exam of a urinalysis, named for what the cast contains. Hyaline casts can be a normal finding. Red cell, white cell, epithelial, granular, waxy, fatty, and broad casts each point to a different kind of kidney condition [1][2].
For what urine casts are and how they form in the kidney, see our urine casts page.
What are the types of urine casts?
The main contents of a cast determine its type [2].
| Cast type | What it contains | What it is linked to |
|---|---|---|
| Hyaline | Protein only (uromodulin, a mucoprotein) | A few can be normal. Dehydration, strenuous exercise, kidney infection, and chronic kidney disease [1][2] |
| Red blood cell (erythrocyte) | Red blood cells | Bleeding from the kidney, as in glomerulonephritis. Can be normal in people who play contact sports [1][2] |
| White blood cell (leukocyte) | White blood cells | Kidney infection (pyelonephritis), interstitial nephritis, and glomerulonephritis [1][2] |
| Renal tubular epithelial | Cells from the kidney tubules | Damage to tubule cells, as in acute tubular necrosis, interstitial nephritis, viral nephritis, or kidney transplant rejection [1][2] |
| Granular | Protein or broken-down cells | Many kinds of kidney disease, including tubular injury such as acute tubular necrosis [1][3] |
| Waxy | Various cell types | Advanced or long-term kidney disease [1][2] |
| Fatty | Kidney tubule cells filled with fat | Fat in the urine, most often with nephrotic syndrome [1][2] |
| Broad | Various cell types | End-stage kidney disease [2] |
Which urine cast types can be normal?
Hyaline casts are the most common type, and a few of them are a normal finding [1]. Red blood cell casts may also be a normal finding in people who play contact sports [2]. Urine normally contains no other cellular casts [1].
Which urine cast types point to kidney disease?
Red blood cell and white blood cell casts are linked to glomerular disease, which affects the kidney’s filters [3]. White blood cell casts help place a urinary infection or inflammation in the kidney rather than the bladder [2]. Granular, waxy, and broad casts are linked to more advanced kidney disease [2].
A cast type is one finding, read together with urine protein, urine red blood cells, urine white blood cells, and kidney blood tests such as eGFR. Talk with your clinician about any cast type other than a few hyaline casts.
Is mucus a type of urine cast?
No. Mucus threads are reported separately from casts on the same microscopic exam. Our guide to mucus in urine explains what a mucus finding means.
Urine cast type testing with Mito
The Urinalysis, Complete Test with Reflex to Urine Culture includes a microscopic exam that reports hyaline casts, granular casts, and a general casts result. Check the product page for current pricing and availability.
Related Urine Cast Type Resources
References
- MedlinePlus Medical Encyclopedia: Urinary casts
- Simerville JA, Maxted WC, Pahira JJ. Urinalysis: A Comprehensive Review. Am Fam Physician. 2005
- Hitzeman N, Greer D, Carpio E. Office-Based Urinalysis: A Comprehensive Review. Am Fam Physician. 2022
Kidney and urinary health tests
Cystatin C with Estimated Glomerular Filtration Rate (eGFR) Blood Test
A kidney filtration marker that stays accurate when muscle mass throws off creatinine.
Comprehensive Metabolic Panel (CMP)
A 14-marker snapshot of kidney function, liver function, electrolytes, and blood sugar in one draw.
