CLS - The Golden Window

Question 1

ELEMENTS OF A URINALYSIS

Answer 1

• pH – high (basic) can mean UTI; also compare to blood pH
• Specific Gravity – high can indicate dehydration
• Protein – should be 0
• Glucose – should be 0 unless diabetic
• Ketones – should be 0 unless diabetes or too much protein consumption
• Blood – blood in urine indicates kidney disease
• Bilirubin – high? Conjugated/unconjugated?
• Leukocyte esterase (WBCs) – indicates UTI
• Creatinine – outside of range can indicate diuresis/antidiuresis
• Cells – should not be cells
• Casts – casts occur if there is bleeding in the kidney
• Sodium – not from UA, need a special tests
  
  • Low can occur with dehydration
  • High can indicate diuresis, tubular dysfunction, or be from diet

Question 2

ACUTE RENAL DISEASE:

CLINICAL PRESENTATION

Answer 2

• Always determine potential indicators of pre/intrinsic/post-renal etiology
• Utilize labs (CBC, CMP) and US
• Always look for comorbidities associated with drugs for other diseases
  
  • Ex: HT diuretics
• Nausea/vomiting indicate pre-renal because less fluid is going to the kidneys
• Intrinsic disease can only be confirmed by biopsy
• Categories of acute renal disease:
  
  • Pre-renal (80% of cases) – decreased kidney perfusion
  • Renal (10% of cases) – intrinsic kidney dysfunction
  • Post-renal (10% of cases) – obstruction