Chapter 4 Urine tests and renal function tests.
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Sample’s collection and sending: A first morning voided urine specimen obtained by a clean catch technique yields the most information. Other collections of urine might have their specific usage ( random urine, postcibal urine, 12 hours urine, 24 hours urine, etc.) The urine should be examined promptly by both chemical and microscopic means.
Chemical tests: include detection the presence of protein, occult blood, glucose and ketone in the urine.
red blood cell glomerulonephritis, vasculitis
white blood cell interstitial nephritis, pyelonephritis
epithelial cell acute tubular necrosis,interstitial
granular renal parenchymal disease (non-specific)
waxy ,broad advanced renal failure
hyaline normal finding in concentrated urine
fatty heavy proteinuria
red blood cell urinary tract infection or inflammation
white blood cell urinary tract infection or inflammation
Tests of glomerular function:
Blood concentration of creatinine (Cr) and urea nitrogen (BUN): Creatinine is a metabolite of creatine, a major muscle constituent. In a given individual, the daily rate of production of creatinine is constant and is determined by the mass of skeletal muscle. Urea is the major product of protein metabolism, and its productoin reflects the dietary intake protein as well as the protein catabolic rate. BUN is often used in conjunction with the Cr as a measure of renal function.
Renal tubular function is evaluated by tests that examine the ability of the kidney to maintain salt and water balance as well as acid-base balance.
History and physical examination : A 48-year- old female patient was admitted with the complains of severe headache with a fever, edema in her face and eyelids for 3 days. From yesterday, she found her amount of urine was decrease once a day . The color of her urine is reddish and cloudy. Physical examination her blood pressure is 180/100 mm Hg , there is severe pitting edema in her face and legs.