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Urinary Epithelial Casts — Microscopic Examination, Number per Low-Power Field

Published: August 9, 2026Updated: August 17, 2026

A urine microscopy test that looks for epithelial cell casts, which can reflect injury or inflammation in the kidney's filtering tubules.

Quick summary

["Epithelial casts in urine may suggest kidney tubule injury, but the result must be interpreted with symptoms and other kidney tests."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 17, 2026Editorial policy

Key facts at a glance

LOINC
5786-9
Short code
Epith Casts #/area UrnS LPF
Synonyms
Epith Casts #/area UrnS LPF
Category
liver
Sample
urine
Container
Sterile urine container
Units
N/A
Ref low
10
Ref high
40
Critical range
— – 500 N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Method
microscopy-light-lpf
CPT
84484
SNOMED
302774002
Specimen volume
10 mL
Stability
Room temperature: 2h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
0
Lipemia max
0
Icterus max
0
TAT
4–24 hours
Order
routine

What is this test?

This test examines urine under a microscope for epithelial casts. These are cylindrical structures made partly of cells shed from the lining of the kidney's filtering tubules.

Why might I need this test?

A clinician may order this test as part of a kidney or urinary tract evaluation, especially when there are symptoms such as swelling, changes in urination, back or flank pain, fever, or unexplained changes in kidney function.

How is the test performed?

A urine specimen is examined microscopically, often after the liquid is centrifuged and the material at the bottom is reviewed. Epithelial casts are typically reported as a number seen per low-power field.

How do I prepare for the test?

Follow the laboratory's urine-collection instructions, which may include providing a clean-catch, midstream sample in a sterile container. No fasting is usually required; tell the clinician about fever, recent exercise, medications, and known kidney problems.

Reference range

Adult: 10-40 U/LN/A

Specimen: urine

No special preparation required. Avoid fatty meals before the test if possible.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urinary epithelial casts

Frequently asked questions

Are epithelial casts the same as a urine infection?
No. Epithelial casts are microscopic structures associated with the kidney tubules and are not by themselves proof of a urinary tract infection.
Does exercise cause epithelial casts?
Temporary increases can occur after vigorous exercise, along with fever or dehydration. Persistent findings or concerning symptoms may require further evaluation.
What other tests may help interpret the result?
A complete urinalysis, urine culture when infection is suspected, and blood tests such as creatinine or estimated glomerular filtration rate may provide additional context.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 17, 2026. · Read our editorial policy