In a routine morning urinalysis, if the major formed elements are hyaline casts and mucus, this sediment is best described as what?

• A. Nephrotic syndrome
• B. Mucus and casts
• C. Granular casts and red blood cells
• D. Normal sediment

Answer: (D)

Hyaline casts are the simplest, most common sediment components and can be seen in normal urine. They form from Tamm-Horsfall protein and are not specific for kidney disease; their presence, especially with only mucus and no other abnormal elements, fits a normal morning urine specimen. Nephrotic syndrome would bring additional findings such as significant proteinuria and lipiduria, and granular casts with red blood cells point to tubular or glomerular pathology. The combination described—hyaline casts with mucus and no other abnormalities—best describes a normal sediment.