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Urine analysis.ppt
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1674029933129437.pptx

  1. 1. Management of patient with urinary syndrome Dr. Neverovskyi Artem
  2. 2. Urinary syndrome • most constant sign of renal and urinary tract disorders. • urinary syndrome includes proteinuria, urinary sediment abnormalities, hematuria, leukocyturia and abnormal amount and/or type of urinary casts
  3. 3. Proteinuria • In healthy individuals, less than 150 mg of protein is excreted in the urine each day. • Transient proteinuria can occur after vigorous exercise, during fever, in heart failure, orthostatic proteinuria • Microalbuminuria refers to the urinary excretion of small amounts of albumin.
  4. 4. Organic proteinuria is of three types 1) Pre-renal proteinuria – when the kidneys are affected secondary to some other disease. 2) Renal proteinuria – when the cause is the kidney disease (glomerular and tubular) 3) Post-renal proteinuria – when the protein is added to the urine after it has left the renal tubules.
  5. 5. • Total 24-hour protein >3 g/day – sign of nephrotic syndrome
  6. 6. Hematuria • Healthy individuals may have occasional red blood cells in the urine (up to 12500 cells/mL) • dipstick testing (15 000–20 000 cells/mL or more) • Microscopy (the presence of 5 or more red blood cells)
  7. 7. Leucocyturia • presence of 10 or more white blood cells per cubic millimeter in a urine specimen • 10 or more white cells per high-power field of unspun urine • urinary dipstick test that is positive for leukocyte esterase • Sterile and non-sterile
  8. 8. UTI
  9. 9. Pyelonephritis
  10. 10. Tubulointerstitial nephritis • TIN is characterized by an immune-mediated infiltration of the kidney interstitium by inflammatory cells • TIN has multiple etiologies, including drug-related, infectious, systemic, autoimmune, genetic, and idiopathic. • The most common cause of TIN is related to a medication or drug exposure • Possible additional symtoms: rash, arthralgia and fever • Blood studies: Renal Failure, Anemia, Eosinophilia • Urine studies: Sterile Pyuria, Proteinuria, Eosinophiluria, White Blood Cell Casts, Micro/Macroscopic Hematuria (rare) • Treatment is based on etiology; aside from removal of offending agents, the mainstay of therapy is corticosteroids, and less often mycophenolate mofetil
  11. 11. Indicator Result Р Reference standards Volume 150 ml Color Straw-yellow Straw-yellow Transparence Transparent Transparent Reaction (pH) 6 5-7 Specific gravity 1021 1015-1025 Protein - < 0,015 g/l Glucose - Negative Ketones - Negative Bile pigments - Negative Microscopic examination Epitelial cell: Flat None-few/lpf None-few/lpf Transitional - None-few/lpf Renal - None-few/lpf Leucocytes 2/lpf in male- up to 3/lpf in female- up to 5/lpf Casts: Hyaline - None-few/lpf Granular - - Red blood cells - 0-1 /lpf Mucus - None-few/lpf Crystals - -

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