Question

57.Diagnostics of kidneys disorders by components of human plasma and urine

(please more explanation Im medicine student) thank you..

Answer 1

Answer :

57)

Renal function tests of plasma or serum includes S.Creatinine, Urea.

In urine examination Albumin, micro albumin, RBC, cast and crystals etc are analyzed to know kidney function.

Glomerular filtration rate is calculated from creatinine, age and sex.

Serum creatinine - In normal renal function, kidneys are responsible for keeping blood creatine level within a normal range. The range is upto 1.2 milli grams per deciliter in men and upto 1 mg/deciliter in females. The level can have a physiological increase in excercise. From the creatinine result we can calculate glomerular filtration rate. Creatinine is the waste product of body from creatine. Creatine is used for muscle contraction. A glomerular filtration rate of 60 or more is considered normal and below shows renal function deficit. A value below 15 indicates kidney failure.

Blood. Urea - Blood urea also reflects glomerular filtration. Blood urea is also kept at a certain lower limit by kidney. In altered renal function, blood urea rises. Normal value of blood urea is below 40 mg/100ml. Blood urea nitrogen can be calculated by dividing blood urea by 2.14.

Urine albumin - normally urine albumin is nil. It's completely reabsorbed by the kidneys, level in urinewill be less than 30 mg/g. However in some infections and high protein diet transient rise in urine albumin to trace amounts can occur. Its represented as trace, 1+, 2+, and 3+. 3+ indicate severe kidney damage.

Urine microalbumin - This helps for early detection of kidney function errors in prone conditions such as diabetes mellitus.

Urine RBC - normally there will be no RBC in urine. Presence of RBC in urine can occur in stone or crystal anywhere in urinary tract from kidney peivis to urethra, or it can occur in glomerulo nephritis. So RBC in urine should be followed up by ultrasound scan.

Urine crystals - urine crystals indicate stone in urinary tract. From the shape of crystal, its easy to identify its type, oxalate or urate carbonate etc. Treatment for each differ.

Urine cast - from the type and shape of cast we can identify certain kidney diseases. RBC cast, waxy cast, epithelial cast are certain examples. Casts are formed in distal convoluted tubules and collecting ducts. They indicate kidney disease rather than urinary tract infections.

Also S.sodium, potassium, RBS etc are assessed as part of renal function test. As there levels are affected in kidney disease.