Urine albumin and small globulins derived from plasma comprise two-thirds of the protein in urine. Under certain conditions, this protein forms a meshwork of fibrils that can trap cells, cell fragments, or granular material. Casts begin to disintegrate in dilute and alkaline urine or in the presence of bacteria, which probably contribute to a decreasing acidity. The size and shape of casts depends on the site of formation. Large casts are seen in dilated tubules or with stasis in collecting ducts.
Thin casts occur in tubules compressed by swollen interstitial tissue or because of disintegration.
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