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Diagnostic and Therapeutic Approach in Kidney Diseases
Diagnostic and Therapeutic Approach in Kidney Diseases
b. Specification of urine
- smell of urine
- frothy urine
- red color (bloody) / haematuria
c. Associated with passing process of the urine
- pain (dysuria)
- no urine (anuria / retention urine)
- frequent small volume (polakisuria)
- insensible urinated (incontinentia urine)
- difficult on passing the urine (stranguria)
PHYSICAL EXAMINATION :
1. Blood pressure
- hypertension ?
2. Edema, ascites ?
3. Lumbal mass
4. Ballottement
- bimanual palpation
5. Percussion pain in angulus costovertebrae
6. Bruit (hearth sound) in abdominal area
SUPPORTING EXAMINATION :
Urine examination
Urine volume :
- anuria (< 100 ml / 24 hrs
- oligouria (<400 ml / 24 hrs)
- polyuria (>3000 ml/24 hrs)
Macroscopic urine
- red color (haematuria)
- frothy urine (proteinuria)
- dirty urine (pyuria)
Microscopic urine
- haematuria
- leucosuria
- albuminuria
- cylinder / cast
ml/mnt
Plasma Cretainin
ml/minute
72 X Plasma Creatinin
IMAGING TEST
1. Radiologic examination
- Plain photo abdomen
- Intra Venous Pyelography
- Retrograde Pyelography
- Antegrade Pyelography
2. Ultrasonographic examination
To investigate the structure of kidney
KIDNEY BIOPSY
Indications :
-
Nephrotic syndrome
Nephritic syndrome
Asymptomatic haematuria
Unknown cause of Acute Kidney Injury
Rejection on kidney transplantation
3. Complication
Hypertensive heart disease
Hyperkalemia