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Introduction ⬇

Granular casts appear homogeneous, coarsely granular, colorless, and very dense. They then further degenerate into finely granular casts. It is not necessary to distinguish the different granular casts. Granular casts may result from degradation of cellular casts, or they may represent direct aggregation of serum proteins into a matrix of Tamm–Horsfall microprotein.

Normal Findings ⬆ ⬇

Occasional, 0–2/lpf (10× objective)

Procedure ⬆ ⬇

  1. Observe the Procedure for Microscopic Urine Examination on pages xxx through xxx of this chapter.

  2. Examine urinary sediment microscopically under low power.

Clinical Implications ⬆ ⬇

  1. Granular casts are found in:

    1. Acute tubular necrosis

    2. Advanced glomerulonephritis

    3. Pyelonephritis

    4. Malignant nephrosclerosis

  2. Granular casts are found with hyaline casts after strenuous exercise or severe stress.

Interventions ⬆

Pretest Patient Care

  1. Explain purpose of test, procedure for random urine sample collection, and interfering factors.

  2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan as needed. Monitor appropriately. Counsel the patient regarding abnormal findings.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.