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Biomarkers of Acute Renal Failure

Hyaline Casts


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Slide 8

August 2009

Hyaline casts are formed by Tamm Horsfall protein, which has precipitated inside of individual tubule lumens. Tamm Horsfall protein is, in fact, the most common protein in the normal human urine, and is secreted by cells in the thick ascending limb. It has a peculiar characteristic of aggregating to form a gel when it is concentrated in urine. If there’s nothing else around when it gels, it forms these hyaline casts, which are normal and only indicate that the patient may have had somewhat concentrated urine at the time it was collected. If there are other cells or structures in the urine at the time Tamm Horsfall protein precipitates, they will be trapped. In fact, Tamm Horsfall protein is the glue that holds casts together.

Hyaline Casts


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