Dipstick Diagnosis Flashcards
What are the 3 stages that renal failure can be split into?
Pre-renal – Most common cause of acute renal failure, e.g. renal hypoperfusion in shock.
Intrinsic renal – Most common cause of chronic renal failure, e.g. polycystic kidneys.
Post-renal – Rare, e.g. obstruction of urinary tract – must occur in both kidneys to have effect
What are the complications of renal failure?
Uraemia – Failure to excrete metabolic waste.
Oliguria – Failure to regulate fluid balance.
Normochromic anaemia – Decreased erythropoeitin production.
Hyperkalaemia and Hyperphosphataemia – Failure to regulate electrolyte balance.
Metabolic acidosis – Decreased renal H+ excretion.
Hypocalcaemia – Reduced 1alpha-hydroxylation, leading to vitamin D deficiency.
What are transport maximums?
The limited rate of reabsorption due to the limited availability of channel proteins (so even in excess concentration, rate of reabsorption plateaus).
Diabetes mellitus
Normally, levels of glucose don’t rise above the limit (300mg/dL) and so we don’t excrete glucose as we reabsorb it all.
In DM, we have a high plasma glucose level and so we end up excreting some glucose as we can’t reabsorb it all into the plasma.
Features include; glucose & ketones in urine and low pH.
What is the specific gravity of urine?
A measure of concentration of excreted molecules within the urine.
What does high specific gravity mean and what does it indicate?
High = high osmolarity = high solute concentration – indicative of dehydration as well as; glycosuria, SIADH, renal artery stenosis and proteinuria
What are urine dipsticks used for?
In non-medical applications like assessing alcohol levels at different points in fermentation progress in beer and wine making.
What is the management of end stage renal failure?
Kidney transplant – average lifespan of 10-years per graft.
Haemodialysis – blood is passed through a dialysis machine 3 times a week for 4 hours a go.
Peritoneal dialysis – performed at home with a peritoneal catheter into abdomen (done 4-5 times a day).
How much inulin is reabsorbed in the kidney?
none
What % of glucose is absorbed in the PCT, LoH, DCT and CD?
ALL IN PCT
What is inulin?
Exogenous substance, freely filtered, not reabsorbed or secreted
Creatine
Creatine is freely filtered and secreted into filtrate but no absorbed so would have over 100%
What would high nitrite is urine suggest?
Bacteria in large numbers
What would high ketone levels in urine suggest?
calorie deprivation, starving, fasting, diabetic ketoacidosis or aspirin poisoning
What would high bilirubin in urine suggest?
cirrhosis, gallstones, hepatitis, tumour of liver/gallbladder
