Question

A nurse is reviewing the urinalysis of a patient admitted to the hospital with a urinary tract infection, nausea and vomiting. The following urine and blood results were obtained:

Urine

Urine specific gravity              1.030

Color                                       Dark Amber

Protein                                     2+

Blood trace

Blood

BUN                                       40

Creatinine 1.2

How would you interpret the importance of the urinalysis?

What is the importance of the BUN and creatinine?

Discuss one disease process that could elevate the BUN.

Answer 1

1. A urine test is performed to check the presence, absence and levels of different waste components present in the urine after filtration through kidneys. Urinalysis is very important to assess the real cause of the patient symptoms; the composition of urine is affected maily by 3 factors like nutritional status, state of metabolic processes and capability of kidneys to handle the components passing through them. In the present scenario of the patient, the different parameters assed include specific gravity= 1.030 which falls under normal range (1.003-1.030), colour = Dark amber which again is under normal; conditions i.e. Pale yellow to dark amber, protein 2+ means around 500-15000mg/24 hours which means it is beyond normal range i.e. <150mg/24 hours indicates kidneys not working properly, blood=traces (hematuria) indicates urinary tract infection or kidneys not working properly (Normally absent)

2. Blood urea nitrogen is thw wate product of protein metabolism and the healthier kidneys excrete them via urine. However, if the kidneys are not functioning properly then it starts accumulating in the blood beyond normal range (7-20mg/dl). Similarly, creatinine is the wate product of muscle metablism and healthy kidneys excrete it via urine. However, in kidney diseases the levels of serum creatine increases beyond normal range of 0.6-1.2mg/dl

3. The current value of BUN= 40mg/dl along with the creatinine levels of 1.2mg/dl which is in the border line of upper normal range (0.6-1.2mg/dl) reflects the patients kidneys are not functioning normally. The increase in bllod/plasma levels indicates that urea production in liver and excretion in urine by kidneys is disturbed, resulting in the elevated levels in blood and is reflective of renal disease/failure.