Waxy Casts in Urine Sediment Microscopy

Morphology of waxy casts in native urine samples at 400x magnification: cracks, hemoglobin impregnation, and associated hematuria.

Daniil Adamov 1 min July 8, 2025

Native urine sample, elongated waxy cast against a background of erythrocytes, x400

Native urine sample, small fragmented waxy cast, x400

Urine sediment, several waxy casts against a background of pronounced hematuria, x400

Native urine sample, wide waxy cast with transverse cracks, x400

Native urine sample, large waxy cast with cellular debris, x400

Urine sediment microscopy, wide waxy cast of complex shape, x400

Native urine sample, massive waxy cast with irregular contours, x400

Native urine sample, large waxy cast with longitudinal defects, x400

Urine sediment, wide waxy cast pigmented with hemoglobin, x400

Beautiful and at the same time terrible waxy casts. Photos 1 - 3 show small, quite harmless (if one can even say that about them) waxy casts. Photos 4 - 9 are examples of large, heavily cracked representatives of this class. It is also worth noting the color of the casts - orange. This coloration is explained by hemoglobin impregnation, which is confirmed by the background of a huge number of dysmorphic erythrocytes. The number of casts per preparation is also impressive. One, and sometimes several, in each field of view. Native urine sample, 400x magnification.

🙏 Material kindly provided by biochemist Daniil Adamov, Moscow