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CLS 426 Urine & Body Fluid Analysis Renal Disease – Part III Interstitial & Vascular Disease

CLS 426 Urine & Body Fluid Analysis Renal Disease – Part III Interstitial & Vascular Disease. Ricki Otten MT(ASCP)SC uotten@unmc.edu. Interstitial Tissue Disease. Lower urinary tract infection Cystitis (bladder) Urethritis (urethra) Acute pyelonephritis (upper UTI) Yeast infection

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CLS 426 Urine & Body Fluid Analysis Renal Disease – Part III Interstitial & Vascular Disease

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  1. CLS 426 Urine & BodyFluid AnalysisRenal Disease – Part IIIInterstitial & Vascular Disease Ricki Otten MT(ASCP)SC uotten@unmc.edu

  2. Interstitial Tissue Disease • Lower urinary tract infection • Cystitis (bladder) • Urethritis (urethra) • Acute pyelonephritis (upper UTI) • Yeast infection • Any bacterial or fungal agent can cause a UTI

  3. Lower UTI • ~85% of lower UTI caused by gram-negative rods (fecal E.coli) • Urinalysis • Physical Color? Clear? • Chemical • Microscopic

  4. Lower UTI • Urinalysis • Physical yellow, hazy (cloudy, turbid) • Chemical ? • Microscopic

  5. Lower UTI • Urinalysis • Physical yellow, hazy (cloudy, turbid) • Chemical + protein (<0.5 grams/24 hr) + leukocyte esterase + nitrite + blood • Microscopic ?

  6. Lower UTI • Microscopic WBC Bacteria RBC Transitional epithelial cells (cystitis) Absence of casts: why?

  7. Acute Pyelonephritis • Most common upper UTI • Two mechanisms causing infection • Bacterial moving from lower to upper urinary tract • Septicemia localizing in the kidneys • Incomplete voiding due to obstruction or dysfunction or anatomic abnormality • Catheterization, pregnancy, diabetes

  8. Acute Pyelonephritis • Urinalysis • Physical Color? Clear? • Chemical • Microscopic

  9. Acute Pyelonephritis • Urinalysis • Physical Yellow, hazy (cloudy, turbid) • Chemical ? • Microscopic

  10. Acute Pyelonephritis • Urinalysis • Physical Yellow, hazy (cloudy, turbid) • Chemical + protein (<1.0 gram/24 hr) + leukocyte esterase (WBC) + nitrite + blood specific gravity: normal to low • Microscopic ?

  11. Acute Pyelonephritis • Microscopic WBC (may see clumping) Bacteria RBC RTE Casts: WBC, granular, RTE, waxy

  12. Yeast Infection • Urinary tract of both men and women are susceptible to yeast infection • Most often vaginal yeast infection contaminates urine • Often caused by Candida species (candida albicans)

  13. Yeast Infection • Candida species (candida albicans) • Normal flora of GI tract and vagina • Normal bacterial flora keep yeast proliferation under control • Catheters provide mode of inoculation

  14. Yeast Infection • Urinalysis • Physical Color? Clear? • Chemical • Microscopic

  15. Yeast Infection • Urinalysis • Physical Yellow, hazy (cloudy) • Chemical ? • Microscopic

  16. Yeast Infection • Urinalysis • Physical Yellow, hazy (cloudy) • Chemical + WBC ? + blood ? • Microscopic Yeast Mycelial elements RBC? WBC? Casts? Why or why not?

  17. Vascular Disease • Any disorder that affects the blood flow to the kidneys can cause renal disease • Cardiac disease (25% of cardiac output) • Atherosclerosis • Hypertension • Diabetes • Eclampsia • Etc

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