Renal Function/Non-Protein Nitrogen Activity

finish

6 functions of the kidney

1. urine function

2. regulates fluid/electrolyte balance

3. regulate acid-base balance

4. excrete waste products (urea/creatinine)

5. Hormone functions (renin/VitD/creatinine)

6. protein conservation

glomerulonephritis urinalysis results

hematuria

increased protein

glomerulonephritis microscopic examination

increased RBC

RBC casts

granular casts

WBC casts

glomerulonephritis other findings

increased urea & creatinine

decreased GFR

nephrotic syndrome urinalysis results

increased protein

nephrotic syndrome microscopic evaluation

oval fat bodies

fatty casts

hyaline and waxy casts

nephrotic syndrome other findings

increased lipids & a-macroglobulin

decreased albumin

pyelonephritis urinalysis result

cloudy

increased protein

nitrite

LE

pyelonephritis microscopic

increased wbc

wbc casts

bacteria

RBC

NPN

nonprotein nitrogenous substance

what NPN is produced by the liver in order to rid the body of ammonia

urea

what reagent is used in the jaffe reaction

alkaline picric

cause of azotemia

decreased renal flow

increased protein intake

enzyme used to measure uric acid in patient samples

ureacase

peroxidase

why should serum uric acid levels be monitored in patients who are on chemotherapy for myeloproliferative disorders

treatment causes increased cellular turnover = increased uric acid which can cause crystals

critical limit (critical cut off) for serum urea

>/= 35.0 mmol/L

common source of error in serum creatinine measurements

ketone

high glucose

vit. c

cyclosporin (antirejection medication)

lipemia

icteric

increased plasma levels of ammonia are useful for confirming what diagnosis

reye syndrome (aspirin ingestion)

severe liver disease

name a special handling technique that is required when collecting samples for ammonia measurement

pre-chilled tube

on ice

centrifuge in cold centrifuge

test asap

what calculation provides earlier detection of chronic kidney disease (does not require collection of 24 hour urine)

eGFR

test for evaluating the kidneys concentrating ability

specific gravity

osmolality

finding rbc casts in urine microscopic is suggestive of which renal disease

glomerulonephritis

increased uric acid

increased creatinine

increased urea

renal failure

primary constituent of urine

water (95%)

lowest to highest urine volume:

oligouria, polyuria, anuria

anuria (none), oligouria (>400), polyuria (>500)

specimen of choice for routine analysis

MSU

why is it possible to estimate the concentration of a normal urine specimen by its colour

darker colour means it more concentrated

how does failure to allow a refrigerated specimen to warm to room temperature before testing affect reagent strip testing

enzymatic reaction strips are temperature dependant

relationship of urine pH to formation of crystals and renal calculi

pH determines if the crystal formation is possible

all clinically significant crystals in ____ pH

acid

urine pH between

4.5-8

what is the significance of a speckled reaction on the blood test strip

speckled = intact rbcs

diagnostic value of nitrite test

to see if bacteria convert nitrate to nitrite

indicator of uti (if LE is present)

false positives of LE reaction

formalin contamination

oxidizers

heavy metals

purpose of 10x for sediment examination

number of casts

purpose of 40x for sediment examination

determine type of cast

type of microscopy that identifies bifringent substances

polarizing

what is the primary wbc seen in urine

neutrophils

describe fat bodies

refractile

absorb lipids

why do casts vary in size and composistion

depends on how long they are in the tube

composition/appearance induced by whats surrounding it

primary constituent that all casts have in common

tamms-horsfall (uromodulin)

primary condition required for the formation of casts

increased urinary protein

what is the renal threshold of glucose in SI units

8.9-10.0

what test is an early predictor of diabetic nephropathy

urine microalbumin

purpose of performing an albumin:creatinine ration

determine state of hydration

what can be done to delay the onset of proteinuria in diabetics

frequent and random urine microalbumin testing

most common calculation for glomerular filtration rate

eGFR based on serum creatinine

nonpathogenic casts

hyaline

pathogenic casts

RBC and WBC