9.2- Kidney Tests Flashcards
What are the 1st line kindey tests (3 categories)
- Serum (creatine, urea, electrolytes)
- Urinalysis
- Creatine clearence
2nd line kidney tests if first idicate a problem (3)
- Serum (calcium, albumin)
- Urine pro
- Osmolarity
of those w known kidney disease 72% didnt have these 2 known risk factors
- High blood pressure
- Diabetes mellitus
What are the major symptoms of kindey disease(4)
-changes in urine volume, color, smell
- Pain in abdomen or on micturition
- oedema, heart failure etc
- itching, skin chanegs etc
What is serum creatine used for and when does it become abnormal
Glomerular filtration test
becomes abnormal when 80% of function is lost
Creatine clearence test
- becoming obsolete
- tests for amount of blood cleared of creatine in unit tim (GFR meaurment)
serum creatine vs creatine clearence
Creatine clearence more sensitive
-clearence is simlpler
If serum creatine clearence is low but pt is well what could that mean (2)
- Preg
- Reduced mm mass
If serum creatine is high but pt is well what could that mean
-Acute or chronic reduction in GFR
false pos = creatine sups
What is the best test to test for early kidney disease
Serum creatinine
What is the back up test to serum creatinine and what does it test forq
serum urea (asseses kidney function)
What could low serum urea suggest
Low pro
What could high serum urea suggest (3)
- High pro diet
- Gastrointestinal hemorrhage
- Pro catabolism
What are the commonly tested electrolytes in kidney tests (4)
sodi
pot
chl
bicarbonate
What are the 2 electros in cell and 2 out
in- pot, magnesium
out- sodium, calcium
Comparing sodium in serum and urine gives an assesment of what
kidney proximal tubular function
If sodium and cholride change in the same direction what could that indicate (2)
- retention/loss of water
2. excress/ loss of NaCl
What is bicarbonate abnormal in (3)
- metabolic diseases
- Kidney diseases
- Lung diseases
What is anion gap and what does a increased anion gap mean
(na + k)- (cl + bicarb)
-increased when another abnormal anion is present (usually due to metabolic diseases
What could calcium and magnesium changes indicate in kidney diseases
Specifically for issues w distal tubule
What do high levels (>50g/l) mean for serum albumin
dehydration
What is serum phosphate changed in (2)
reciprocal of serum calc (if calc low then phosphate high)
-will be low w low vit d
Why would serum albumin be low (<35g/l)
- liver diseases
- kidney diseases
- chronic starvation
(will have obvious oedema)
How should u sample urine
<4hrs old
-most conc sample overnight
-for metabolic diseases (diabetes) sample taken 2 hrs after meal
what could anuria and oliguria suggest (2, 1)
anuria- kidney failure, obstruction
oliguria- kidney ischemia
What does deep yellow, red, black urine suggest
deep yellow- riboflavin
red0 haemoglobin
black- old blood, bleeding in kidney
What could a small amount constant pro, and large, false pos amount suggest
small constant- early kidney failure
large- nephrotic syndrome
false- Quaternary amonia, chlorohexidine
What could a small amount constant pro, and large, false pos amount suggest
small constant- early kidney failure
large- nephrotic syndrome
false- Quaternary amonia, chlorohexidine
What could cause glucose overload (2) and flase neg
Diabetes, preg
false neg- Vit C
What could keytones present suggest (2)
Diabetes, preg
What could hypersthenuria suggest (>1.010), (2)
-Dehydration, diabetes
What would cause bilirubin/urobilinogen to be present
Liver disease
What would pos nitrates sigest
Uti from bacteria such as e coli (mc)
if nitrites, leucocytes, blood are present on dipstick
94%
What could casts of tubules suggest in microscopy
Dehydration
UTI
red cell casts= infection in kidnet
what could crystals in microscopy suggest
Metabolic
UTI
stones
What could epithelia suggest
tubular disease
Pos PSA result suggest prostate cancer what % of the time
50% of the time
