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Diagnostic Procedures

Urinalysis
Analysis of the urine affords enormous insight into the function of the kidneys. The first step
in urinalysis is doing a dipstick test. The dipstick has reagents that check the urine for the
presence of various normal and abnormal constituents including protein. Then, the urine is
examined under a microscope to look for red and white blood cells, and the presence of casts
and crystals (solids).

Only minimal quantities of albumin (protein) are present in urine normally. A positive result on a
dipstick test for protein is abnormal. More sensitive than a dipstick test for protein is a laboratory
estimation of the urine albumin (protein) and creatinine in the urine. The ratio of albumin
(protein) and creatinine in the urine provides a good estimate of albumin (protein) excretion per
day.

Latest result
Macroscopic Microscopic

Color Light yellow RBC 12-15 / HPF

Transparency Cloudy WBC Many / HPF


Specific 1.015 Epithelial Cells Moderate
Gravity
Reaction 6.0 Mucus Threads Few
Chemical Bacterial Many
Tests
Negative Crystals
Sugar
A. Urates
Albumin Trace Many
Special Tests A. Phosphate

Foam’s test Calcium


Coxalate
Ketone Others
Pregnancy test
Analysis and Interpretation:

Laboratory results revealed that there is presence of albumin in


the blood and no sugar present.

1st result
Macroscopic Microscopic

Color Light yellow RBC 2-3 / HPF

Transparency Slightly WBC 2-3 / HPF


cloudy
Specific 1.020 Epithelial Cells Few
Gravity
Reaction 5.0 Mucus Threads Occasional
Chemical Bacterial Few
Tests
+2 Crystals
Sugar
A. Urates
Albumin +3 Moderate
Special Tests A. Phosphate

Foam’s test Cast Coarse granular


3-5 / LPF
Ketone Others Waxy cast 2-4 /
PLF
Analysis and Interpretation:

Laboratory results revealed that there is presence of albumin and


sugarin the urine.

Blood test
Creatinine and urea (BUN) in the blood: Blood urea nitrogen and serum creatinine are the
most commonly used blood tests to screen for, and monitor renal disease. Creatinine is a
product of normal muscle breakdown. Urea is the waste product of breakdown of protein. The
level of these substances rises in the blood as kidney function worsens.

Estimated GFR (eGFR): The laboratory or your physician may calculate an estimated GFR
using the information from your blood work. It is important to be aware of your estimated GFR
and stage of chronic kidney disease. Your physician uses your stage of kidney disease to
recommend additional testing and suggestions on management.

Electrolyte levels and acid-base balance: Kidney dysfunction causes imbalances


in electrolytes, especially potassium, phosphorus, and calcium. High potassium (hyperkalemia)
is a particular concern. The acid-base balance of the blood is usually disrupted as well.

Decreased production of the active form of vitamin D can cause low levels of calcium in the
blood. Inability to excrete phosphorus by failing kidneys causes its levels in the blood to rise.
Testicular or ovarian hormone levels may also be abnormal.

Blood cell counts: Because kidney disease disrupts blood cell production and shortens the
survival of red cells, the red blood cell count and hemoglobin may be low (anemia). Some
patients may also have iron deficiency due to blood loss in their gastrointestinal system. Other
nutritional deficiencies may also impair the production of red cells.

Hematology
Resul Normal Analysis
t
WBC 10.4 4.0- Normal
11.0x10^9
/L
RBC 2.36 4.0- Result was below normal.
6.0x10^12 This indicates alteration in
/L erythropoietin production
secondary to renal
malfunction.
HGB 70 120-180 Result was below normal.
g/L This shows the decrease in
the oxygen carrying capacity
of the blood secondary low
hematocrit.
HCT 0.22 0.370- Result was below normal,
4 0.540 thus showing anemia related
to insufficient RBC
production.
MCV 94.8 20-100fL Normal
MCH 29.6 27-31pg Normal
MCHC 312 320-360 Result was below normal
g/L
RDW 15.2 11.5-15.0% Normal
Differential
count
01 2-6% Result was below normal
Bands
Segmented 93 50-70% Result was above normal
Lymphocytes 05 20-44% Result is above the normal
range, indicating bacterial
infection.
Monocytes 01 2-9% Result was below normal

Test Resul Unit Normal Resul Uni Normal Analysis and


t values ts t values Interpretation
conv.

Creatini 674 umo 53.0 1.3 11.50 mg 0.6 1.3 Result was
ne high l/L 0 0 /dl 0 0 above normal
thus showing
inability of the
kidney to
excrete
nitrogenous
waste.
Sodium 133 mm 136 14 122.0 mE 13 14 Result was
low ol/L 8 0 q/d 6 8 below normal
l thus showing
the fluid and
electrolyte
imbalance.
Potassiu 2.5 mm 3.65 5.2 6.30 mE 3.6 5.2 Result was
m low ol/L 0 q/d 0 0 below normal
l thus showing
the fluid and
electrolyte
imbalance.

Test Resul Unit Normal Resul Uni Normal Analysis and


t values t t values Interpretation
conv.
Creatini 674 umo 53.0 1.3 7.62 mg 0.6 1.3 Result was
ne high l/L 0 0 /dl 0 0 above normal
thus showing
inability of the
kidney to
excrete
nitrogenous
waste.
Sodium 133 mm 136 14 133.0 mE 13 14 Result was
low ol/L 8 0 q/d 6 8 below normal
l thus showing
the fluid and
electrolyte
imbalance.
Potassiu 2.5 mm 3.65 5.2 2.50 mE 3.6 5.2 Result was
m low ol/L 0 q/d 0 0 below normal
l thus showing
the fluid and
electrolyte
imbalance.
Ultrasound
Ultrasound is often used in the diagnosis of kidney disease. An ultrasound is a noninvasive
type of imaging test. In general, kidneys are shrunken in size in chronic kidney disease,
although they may be normal or even large in size in cases caused by adult polycystic kidney
disease, diabetic nephropathy, and amyloidosis. Ultrasound may also be used to diagnose the
presence of urinary obstruction, kidney stones and also to assess the blood flow into the
kidneys.