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Question 1

How to differentiate glomerular disease from renal tubular disease? (2)

Answer 1

tubular epithelial cell cast
beta-2 microglobulin (Excreted by glomerulus & reabsorbed by tubules [PCT damage in Fanconi syndrome due to heavy metal & drugs])

beta-2 microglobulin is also a tumor marker (leukaemia, as it is part of MHC1)

Question 2

Why do we measure 24h urine CA, MG, PHOS, UA? (1) Why container with HCL is required for CA,MG,PHOS? (1) How about UA? (1) Can we do urine NA,K with an acidified urine sample? (1)

Why container with HCL is required for CAT? (1)

Answer 2

Ix nature of kidney stone if exist.
Acidity prevent salt ppt.
NaHCO3 alkaline is require for urine UA.
pH change in sample affects NA,K measurement with ISE.

HCL for CAT:
1. CAT degradation by bacteria
2. CAT is unstable in alkaline (cases of alkaline urine / AMM production by urease-producing bacteria)