Renal labs Flashcards by Shae taylor

Name the renal function tests

BUN
Creatinine
Urinalysis

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BUN stands for and measures what

blood urea nitrogen

measures concentration of nitrogen (urea) in serum

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Normal BUN

8-20mg/dl

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What is the BUN a marker of?

Protein metabolism

–Kidney failure
–CHF, acidosis

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Creatinine is a catabolic product of _____

creatine (important in skeletal muscle contraction)

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Daily production of creatinine depends on ______ _____

muscle mass

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Creatinine is entirely excreted by______

Kidneys

Directly related to renal function

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T/F: a person with increased muscle mass can have higher creatinine values

True

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NL value for creatinine

0.5-1.1 mg /dl

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Elevation of creatinine suggests?

Chronicity of renal disease

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A doubling of creatinine equals a ______% decrease in renal function.

50%

1.0 - 2.0 is doubling

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2 groups that may have lower levels of creatinine

females

debilitated c muscle wasting

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NL creatinine clearance? males vs female

90-140 ml/min

Males: 107-140
Females: 90-107

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Why is GFR important.

Proper dosing and treatment decisions

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What test most accurately assesses GFR?

inulin filtration rate

not available clinically

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What is CrCl used for?

assessing kidney fx
Monitor drug therapy
monitor therapetuic drugs and determine doses

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CrCl requires 2 things:

24 hr urine

serum drawn w/in 24 hrs of urine collection

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Estimated Glomerular filtration rate (EGFR) has what advantages over CrCl?

no need for 24hr urine collection

- quick, from BMP

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What equation estimates crcl without 24hr urine study?

Cockcroft-Gault equation

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MDRD stands for?

Modification of diet in renal disease

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MDRD equations incorporates what into the equation?

age
Sex
ethnicity

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Stage 1 CKD

GFR 90 or higher

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Stage 2 CKD

GFR 60-89

Mild loss

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Stage 3a CKD

GFR 45-59

mild to mod

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Stage 3b CKD

30-44 | Mod to severe loss

Stage 4 CKD

GFR 15-29 | Severe loss

Stage 5 CKD

GFR<15 | Kidney failure

Urinalysis consists of what 2 tests?

Dipstick | Microscopic analysis

Dipstick strips measure what 9 things?

``` Specific gravity pH Glucose Protein Ketones blood bilirubin nitrite leukocyte esterase ```

NL pH of urine?

4.5-8.0

What time frame is a urine sample usable?

with in 24 hrs

NL specific gravity of urine?

1.010 - 1.025

High specific gravity indicates.

concentrated urine | dehydration

Low specific gravity indicates.

dilute urine renal failure over hydration

What ion is the main contributor to SG?

Na+

NL ketones in urine?

Negative

Strips testing urine will pick up which ketones type?

Acetoacetic acid

T/F: excessive vomiting and dehydration would not cause ketones in the urine?

False. | This causes the body to break down muscle and urine would be + for ketones

T/F: glucose is normally found in urine

false | Glucose is usually negative in urine

What is the renal threshold for glucose spillage into urine?

250-300mg/dl

NL protein in urine?

Negative

If ______ _____ is injured, protein will be elevated in the urine.

Glomerular membrane

Proteinuria + edema =

nephrotic syndrome

What is a sensitive indicator of kidney function?

Protein in urine

T/F: you can have trace amounts of protein in urine after exercise

True

NL bilirubin and urobolinogen

Negative

bilirubin and urobolinogen are elevated when?

Liver dmg | obstruction of bile duct

Which is more sensitive for detecting blood in urine? Dipstick or microscopic analysis?

Dipstick - can pick up lysed cells

What condition can cause false positive for blood in urine?

Crush injury - myoglobin

what can cause a false negative for blood in urine?

high levels of Vit c

what condition should you highly suspect with painless hematuria?

bladder ca

What condition is leukocyte esterase postive in?

UTI

Leukocyte esterase is ____% accurate in detecting WBCs in urine?

90%

Nitrite is positive in which condition?

UTI

____ of urine can interfere with test of nitrite

Color of urine Would give false+

Gram ( ) bacteria produce_____ which converts nitrate to nitrite

Gram - (but some gram + can as well) | Reductase

Microscopic UA looks for what?

WBC RBC epithelial cells casts

WBC on microscopic UA =

infection

If you find sterile pyuria (WBC in urine) what condition should you think

RBC on microscopic UA =

infection | renal calculi

Eosins on microscopic UA =

interstitial nephritis

Hyaline casts

NL after exercise | Chronic renal failure

RBC casts

glomerulonephritis | Subacute bacterial endocarditis

WBC casts

pyelonephritis

Epithelial Casts

tubular necrosis

Granular casts

nephrotic syndrome | lead toxicity

Waxy casts

renal failure | acute tubular necrosis

Where do casts form

distal and collecting tubules