Granular casts in urine at 12 weeks?

[StaceymReadyForNumber3]

Had my urine tests done at booking in and they show i have granular casts in my urine, the docs don't seem to know what the midwives want to do so are checking it out, but i have no idea what they are/how they are caused.

I really don't want to google it for fear of scaring myself, please can anyone with some knowledge help?!

This is an old post and there are no replies, but I'd love to hear what the outcome of this was or if anyone else had this.

My urine test came back with epithelial cells and granular casts "seen". They asked me to go back to do a repeat test, awaiting results. From googling (dangerous, I know!), this seems to relate to Kidney damage or disease, so i'm quite worried. If anyone can share their experience I'd be grateful!!

Have you done any strenuous excercise recently?

The thing with lab tests is that you need the full context to interpret them properly.

If you get two blokes in with really high CK levels for example, it could be indicative of a heart attack. But then you ask them for a medical history - bloke A is 40 and has spent the last twenty years on the sofa whereas bloke B is 55 and a keen runner who has just done his first triathlon. Since high CK levels can result from exercise induced muscle breakdown (normal process) we can assume that bloke B is probably ok.

granular casts plus epithelial cells could indicate kidney dysfunction, but it can also be caused by strenuous activity, infection, septic shock, etc.

They may want to do some further tests on you to see how well your kidneys are functioning. Hope it's ok - do write down the questions you have to take to your doc when you see them x

Like many things understanding of normal is difficult in pregnancy as it hasn't been extensively researched. Kidney function is different (your kidney filtration goes up massively for example which may be a factor in some women getting protein in their urine)

Some large observational series identified low levels of granular casts in the urine in pregnancy. That may make sense if you consider that excretion of white cells in urine changes and granular casts may be degraded white cell casts.

So a single isolated result may not mean a thing. You need further tests for unary sediment (blood and protein) & possibly a protein creatinine ratio. Midwives are unlikely to be knowledgeable about this - if a problem on renal bloods or urine tests you will need to see a nephrologist (preferably in a joint renal / pregnancy clinic). This could genuinely mean nothing at all though