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INVESTIGATIONS OF URINARY SYSTEM

INVESTIGATIONS OF URINARY SYSTEM. In Blood Serum Urea: Normal level 2.5-6.6 mmol/l (15-40mg/dl) High level can occur in high protein diet, GI bleeding, trauma, hypovolemia, burn. Low level can occur in low intake, liver failure, over hydration. Serum Creatinine:

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INVESTIGATIONS OF URINARY SYSTEM

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  1. INVESTIGATIONS OF URINARY SYSTEM DR. S Chakradhar

  2. In Blood • Serum Urea: • Normal level 2.5-6.6 mmol/l (15-40mg/dl) • High level can occur in high protein diet, GI bleeding, trauma, hypovolemia, burn. • Low level can occur in low intake, liver failure, over hydration. • Serum Creatinine: • Normal level 55-120mmol/l (0.62-1.36 mg/dl) • High level can occur in large muscle mass, rhabdomyolysis, drugs like trimethoprim, cimetidine • Low level can occur in small muscle mass. • Serum potassium: (Serum sodium) • Normal level 3.7-5.2 mmol/l • False high levels can occur in hemolysed sample DR. S Chakradhar

  3. Urine examination Broadly divided into • Routine • Special Routine • Physical Examination • Chemical examination • Microscopic examination DR. S Chakradhar

  4. Physical examinations includes • Amount (Volume) – 800 – 2500 ml / day • Odour - Pungent • Color of the urine – Straw colour • Appearance – Clear & transparent • Specific gravity – 1.010 – 1.030 DR. S Chakradhar

  5. Chemical examinations includes • Reaction – Acidic (avg 6) • Protein (24hrs urine) – less than 150mg/24 hour • Glucose (reducing substance) • ketones DR. S Chakradhar

  6. Microscopic examinations includes • Cells • Epithelial cells – normally found in samall number • WBC ( Pus cells ) • RBC ( normal, dysmorphic ) • Others • Casts --RBC casts, WBC casts, epithelial casts, granular casts • Crystals - uric acid, calcium oxalate, triple phosphate, calcium carbonate etc DR. S Chakradhar

  7. DR. S Chakradhar

  8. Estimation of GFR Calculation of creatinine clearance Cockcroft and Gault: • {(140-age) X body weight X 1.22 (male) and 1.04 (female)} Divided by serum creatinine in μmol/l More accurate method: • {Urine creatinine×urine volume} X 1000divided by serum creatinine 1440 Normal range: • Men 90-140 ml/min • Women 80-125 ml/min. DR. S Chakradhar

  9. Imaging • Plain X-Ray abdomen DR. S Chakradhar

  10. Excretion urography(IVP/IVU) • Antegrade • Retrograde DR. S Chakradhar

  11. Excretion urography(IVP/IVU) • Antegrade • Retrograde DR. S Chakradhar

  12. Micturatingcystourography DR. S Chakradhar

  13. Ultrasound DR. S Chakradhar

  14. Renal angiogram DR. S Chakradhar

  15. Computed tomogram (CT) DR. S Chakradhar

  16. Magnetic resonance imaging (MRI) DR. S Chakradhar T1-weighted axial image without & with contrast medium

  17. Radionuclide studies (DMSA and DTPA) DR. S Chakradhar

  18. Renal biopsy DR. S Chakradhar

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