1 / 19

Abnormal constituents of urine & renal function tests

Abnormal constituents of urine & renal function tests. UST. AZZA MAHGOUP. Abnormal constituents of urine. 1. Proteins: a. Albumin ( Albuminurea ): When only small amounts of albumin may leak into the urine, a condition known as microalbuminuria , a sign of deteriorating kidney function.

imaran
Download Presentation

Abnormal constituents of urine & renal function tests

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Abnormal constituents of urine& renal function tests UST. AZZA MAHGOUP

  2. Abnormal constituents of urine 1. Proteins: a. Albumin (Albuminurea): When only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of deteriorating kidney function. As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria.

  3. Abnormal constituents of urine b. Hemoglobin(hemoglobinurea): It indicates intravascular hemolysis as in malaria & hemolytic anemia. Color of urine is brown due to presence of free Hb. c. Myoglobin(myoglobinurea): It indicate massive muscle damage as in burns & severe electric shock.

  4. Abnormal constituents of urine 2. Sugars: a. Glucose( glucosuera): It is mainly related to defects in carbohydrate metabolism. It found in patient of diabetes . b. Galactose ( galactosurea): Can be found in person with the rare congenital metabolic disorder called galactosemia. In this disease the enzyme which convert galacotse to glucose is deficient. c. Lactose ( lactosurea): It occur in infants, in mothers during pregnancy and lactation.

  5. Abnormal constituents of urine 3. Ketone bodies ( ketonurea): Can be found in urine of untreated diabetics or person suffering from starvations. 4. Bilirubine: Can be found in urine of person of hepatocellular jaundice or cholestatic jaundice. The color of urine is orange or yellow orange.

  6. Abnormal constituents of urine 5. Blood( heamaturea): It is presence of blood of intact RBCs in urine. It caused by urinary glomerulonephritis & malignant diseases. Colour of urine is red.

  7. RENAL FUNCTION TESTS

  8. plasma creatinine plasma urea urine volume urine urea urine protein urine glucose hematuria Laboratory tests of renal function

  9. Blood Urea Nitrogen BUN • Urea is the nitrogenous end-product of protein & AA metabolism. • Urea is formed in the liver when ammonia (NH3) is removed and combined with CO2 (urea cycle). • 40% to 80% of the filtered urea is passively reabsorbed with water, mostly in the proximal tubules. • Majority excreted in urine • Most widely used screening test of kidney function

  10. Plasma urea Urea production depends on non-renal variables. Increase Decrease High protein intake Low protein intake Gastrointestinal bleeding Severe liver disease Hypercatabolic state Dehydration Urinary stasis Serum Urea = 8-25mg/dl .

  11. Creatinine (Cr) • Creatinine is freely filtered by the glomeruli but is not reabsorbed to any extent under normal circumstances. • A substantial fraction of creatinine excretion by the kidney is the result of proximal tubular secretion. • Serum creatinine concentration is often interpreted as a measure of glomeurlar filtration rate and is used as an index of renal function in clinical practice.

  12. Creatinine (Cr) • Normal serum level 0.7-1.5 mg/dl. • In order to see increased creatinine in serum, 50% kidney function is lost • Best test for overall kidney function; not affected by diet or hormone levels. • Creatinine level is affected by muscle mass, creatine turnover & renal function.

  13. As a kidney function test, urea is inferior to serum creatinine because:

  14. High protein diet increases urea formation. • Any condition ofproteins catabolism (Cushing syndrome, diabetes mellitus, starvation, thyrotoxicosis ) urea formation. • BUN influenced by diet and hormones such as steroid hormones , so it is NOT as good an indicator of renal function as serum creatinine levels

  15. Uric acid • Final breakdown product of nucleic acid catabolism(purine)- from both the food we eat, and breakdown of body cells. • Uric acid is filtered by the glomerulus, majority reabsorbed by the proximal convulated tubule & distal tubule.

  16. Uric Acid • Roles • Assess inherited purine disorders • Confirm diagnosis and treatment of gout • Assist in diagnosis of renal calculi • Detect kidney dysfunction • Reference values: 3 - 9 mg/dl

  17. Clinical Significance: Uric Acid • Gout • Increased plasma uric acid • Painful uric acid crystals in joints • Usually in older males ( > 30 years-old) • Associated with alcohol consumption • Uric acid may also form kidney stones • Other causes of increased uric acid • Leukemias and lymphomas (  DNA catabolism ) • Megaloblastic anemias (  DNA catabolism ) • Renal disease ( but not very specific )

  18. Ammonia • Formed from the breakdown of amino acids and bacterial metabolism • Metabolized by the liver • Increases due to renal failure or liver disease are toxic to the CNS

  19. One final note… • Remember the Renal panel • Albumin • Glucose • BUN • Creatinine • Calcium • Chloride • Potassium • CO2 • Sodium • Phosphorus

More Related