ASSESSMENT

OF KIDNEY
DISEASES BY
URINALYSIS

PRESENTED BY

GROUP A
URINALYSIS

– INCLUDE :
1) Physical examination
Volume, Color, SG, appearance

2) Chemical examination
Protein, Glucose, Ketone, Bilirubin, urobilinogen, Nitrites, Leukocyte esterase

3) Microscopic examination
RBCs, Pus cells, Epithelial cells, Sperm, Casts, Crystals, Organisms
Volume (800-2000ml/day)

Polyuria >3000ml/day

Renal causes: – Other causes

Chronic renal failure Diabetes mellitus
Diabetes insipidus
Diuretics
Adrenal aplasia
Caffeine
Oliguria <400ml/day

Kidney problems Others

– Acute glomerulonephritis – Congestive heart failure
– (due to dec. GFR) – Dehydration
Anuria >100ml/day

Kidney problems Others

– Acute tubular necrosis – No significant other causes
(e.g in shock, transfusion reactions)
– Acute glomerulonephritis
(dec. GFR)
– Complete urinary tract obstruction
Color (pale yellow)

Kidney problems Others

– Red urine
Due to:
Trauma, stones, malignancy
Turbidity (not seen normally)

Kidney problems Others

– UTI – STDs
– Genitourinary tuberculosis – Drugs e.g paracetamol
– Sepsis
Specific Gravity (1.015-1.025)

Dec. SG Inc. SG
– Kidney problems – Kidney problems

Chronic renal failure due to loss of – Nephrotic syndrome due to

proteinuria
concentrating ability of tubules
– Others
– Others
– Diabetes mellitus
Diabetes inspidus
– Multiple myeloma
– Dehydration
Protein

Kidney problems Others

– Diseases that damage glomeruli – Increased circulating levels of
(e.g glomerulonephritis, nephrotic protein
syndrome, nephritic syndrome, renal
– Due to low reabsorption of
infection, hypertension, diabetes)
proteins at proximal tubules,
Pathophysiology : Fanconi’s syndrome
Glomerular injury leads to increased
– Vigorous exercise
permeability of glomeruli, proteinuria
will be the result.
Glucose

Kidney problems Others

– Benign glycosuria
Rare condition in which filtering
system of kidney allows glucose to
pass into urine
– Diabetes mellitus
– Hyperthyroidism (causes inc.
glucose level)
– Liver diseases (depressed
carbohydrate metabolism)
– High sugar diet
– Emotions
RBCs
(Visible Hematuria)

Painful Painless
– Kidney stones – Renal tumors
– Infection of the lower urinary tract – Cystic tumors
– Pyelonephritis
– Poolycystic kidney disease
– Trauma
Blood(RBCs)
Microscopic Hematuria
Glomerular
– Glomerulonephritis
– Hereditary nephritis(Alport’s
disease)
– Lupus nephritis
– IgA nephropathy
Non-glomerular
– Tumor (Renal or cystic)
– Infection
– Tuberculosis, pyelonephritis,
hydronephrosis
– Polycystic kidney disease, trauma
– BPH, Carcinoma of prostate
Nitrites

Nitriuria
Others
– UTI
(Caused by gram negative bacteria)
Ketone

Kidney problems Others

– Not significant in detection of – Uncontrolled diabetes
kidney problems – DKA
– Starvation
– Anorexia nervosa
– Alcohol dependency
– Ketogenic diet
Urine WBCs (0-2/HPF)

– Urinary tract infection

– Genitourinary tuberculosis
– Kawasaki disease
– STDs
– In pneumonia (older people)
– Acetaminophin toxicity
Epithelial cells(<5/HPF)

– Increased in:
– Infections (UTI)
– Inflammation
– Malignancy
Abnormal urinary crystals

– Cholesterol crystals:
– seen in nephrotic syndrome and in conditions producing chyluria and are always
considered abnormal.
– Cystine crystals:
observed in;
homocystinuria
cystinuria
Casts

 Granular casts: (degeneration of cellular casts, aggregates of proteins)

• Chronic renal disease
• Acute tubular necrosis
• Sternous exercise
 Waxy casts: (renal failure casts)
• Severe chronic renal diseases
• Renal amyloidosis
Casts

 RBC casts
– Pyelonephritis
– Glomerulonephritis
– Acute interstitial nephritis
– Lupus nephritis
 WBC Casts
– glomerulonephritis
– Epithelial casts
– Kidney transplant rejection
– Viral diseases
– Renal tubular necrosis
Summary
Summary of deposits
Thank You