Lab Exam Renal Function Test

8/13/2019 Lab Exam Renal Function Test

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Block 3.3Faculty of MedicineUniversity of Gadjah Mada

RENAL FUNCTION TESTS:samples,urinalysis, other

dr. Harjo Mulyono SpPK-KClinical Pathology Dept

Ref:Ravel: Clinical Laboratory Medicine;Clinical Application of Laboratory

DataWalmsley: Cases in Clinical Pathology


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Laboratory examination of kidneya.purpose

laboratory examination

(of kindneys function)

screening diagnostic/prognostic monitoring

urinelysis urinelysis urinelysis

RFT RFTTDM

methodes of laboratory examinationanalytically, diagnostically

sensitivity,specificity


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Laboratory examinationb.sampling

Urinelysistyp e of samp le indic ate

1.randomized quality measured2.fasting urine DM (screening for DM)

3.2 hrs after meal DM (screening for DM)4.morning urine qualitative: hormonal

(pregnant:urine hCG)5.24 hrs urine quantity measured

(volume, electrolytes,urea, protein, creatinin,sugar, clearence, GFR)

6.midstream; catether,spp microbiology test


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Laboratory examinationc.urinelysis

Urinelysis

physical test chemist test microscopic test

dry chemistry wet chemistry

stick conventional test flowcytometry test

result (color) 1.centrifugation of10 ml urine volume 20L 2.centrifugation:fixed angel cells: rbc, wbc -

photometer 3.centrifugation epithels polimorphyc 4.kinds of Xtals bacterie

quantity 5.kinds of cells casts6.kinds of casts Xtal 7.quality,semiquantity quantity (L)


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Laboratory examinationurinelysis

dry chemistry-stick technique


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urinelysisdry chemistry test

stick technique


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Urinelysischemist exam, dry chemistry test

automatic technique


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urinelysistests and sample types:Laboratory exam:sample types:morning urine,urine randoma.Urinelysis: formation, excretion urine

diseases of: urinary tractnon urinary tract

test: physical:appearance: clear

color : pale yellowgravity : 1,010-1,020odor : specificvolume : 1 1,5 L/24 hrs


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urinelysischemist:reaction :acid (pH6-6,5)

protein (albumin) :nonglucose :non

ketones :nonbile :nonurobilinogen :normalurobilin :normal

nitrite :nonleucocyte esterase:normal (25uL)blood (Hb) :non


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Laboratory examinationd.renal function test

d1. glomerular functions test

Test for the glomerular function (GFR)1.clearence

conditional?kinds:PAH (para amino hipuric) Inulin

Diodrast ureacreatinin

parameters: urine: volume/minute,creatininblood: creatininbody surface: body weight, height

Formula: Cl c r=(CrU:CrB)X Urine vo l/m nt Xfactor (m L/mnt)

clearence standard (urin e vo l2m l/mn t)

alternative test:Cockroft-Gault:{(140-age) X BW} : (BCr X 72)


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Laboratory examinationrenal function test

d1. glomerular functions test

2.Cys tatin C : measured cystatin C in plasma*produce in all nucleus cell*protein MW


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Laboratory examinationd.renal function tes

d1.glomerular functions test

4.Microalbuminuria*protein does not free filtration, small proteindoes filtered in glomerular, reabsorption in prox

tub*normobumin:albumin in urine less (200 g/dl

*clinical identification: glomerular thicknesscardiac hypertentionnephropatia diabetica


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Laboratory examinationd.renal functions test

d2.others functions test d2.1.Test for tubular function

reabsorbsi&excretion: Fractional excretion of NaFe(Na)={U[Na]XP[creat]}:{P[Na]XU[creat]}X100%

d2.2.Dilution test:

ps give 1000ml water,fast in 30 minutes07 AM ps give 1000ml/30minutespt collected urine at 08.30;09.30;10.30;11.30 AMpositive result:total urine 1000 ml, one of sample SG 1,030


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case report:Wati, a woman 52 years old, has low back pain,dysurie

Urinelysis:physic: color:redish; SG:1,028; pH:6,4chemist:protein:pos; bile:neg urobilinogen:normal

glucose:neg; ketone:neg; nitrit:pos

blood:pos; leucocyte: posmicroscopic: leucocyte:10-12/VF; RBC:10-12/VFcrystal: Ca ox; bacterie:positive


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Ahmad, a man 45 years old, hypertension,Lab exam: fasting glucose: 160g/dl

2 hrs glucose:220 g/dldyslipidemia

What the next lab exam?


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matur nuwunkawigatosanipun

Lab Exam Renal Function Test

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