Laboratory investigation of kidney disorders,

1. LABORATORY
INVESTIGATIONS OF
KIDNEY DISORDER...
RITU M PATIL
DEPARTMENT OF BIOCHEMISTRY

2. CONTENT:
• Introduction
• Laboratory tests
• Diagnosis,
• Symptoms,
• Prevention and treatment of
• Urolithiasis
• Hypouricemia

3. INTRODUCTION:
 Kidneys are the small bean shaped organ in the human body that plays a crucial role in
maintaining overall health and balance.
 These functions include filtering waste and excess fluids from the blood to form urine, regulating
electrolyte levels, producing hormones that influence blood pressure and maintaining the body's
acid-base balance.
 Laboratory techniques provide quantitative and qualitative data about kidney function.
 Laboratory tests allow healthcare professionals to identify kidney disorders at their earliest stages.
This early detection enables timely intervention and treatment, potentially preventing further
damage and complications.
 Laboratory tests help gauge the effectiveness of treatments by measuring changes in kidney
function over time.
 laboratory techniques used for kidney disorders are not just diagnostic tools; they are the
foundation of informed medical decisions that enhance patient care, improve outcomes, and
contribute to the overall advancement of kidney health understanding.

4. LABORATORY FOR OR TESTS:
1. Urinalysis: This involves analysing a urine sample for abnormalities such as proteinuria (protein in
the urine), hematuria (blood in the urine), and changes in specific gravity. Urinalysis provides insights
into kidney function and potential disorders.
2. Serum Electrolytes (Sodium, Potassium, Calcium, Phosphorus): These tests measure levels of
essential electrolytes. Imbalances can indicate kidney dysfunction, as the kidneys play a crucial role in
maintaining electrolyte balance.
3. Albumin-to-Creatinine Ratio (ACR): ACR measures the ratio of albumin (a protein) to creatinine in
the urine. Elevated ACR indicates kidney damage, especially in diabetes-related kidney disorders.
4. Kidney Imaging (Ultrasound, CT Scan, MRI): Imaging techniques visualize the kidneys' structure,
size, and presence of abnormalities like kidney stones, tumors, or cysts. They aid in diagnosing
structural kidney problems.
5. Renal Biopsy: In this procedure, a small sample of kidney tissue is extracted for microscopic
examination. It helps diagnose kidney diseases, determine the extent of damage, and guide treatment
decisions.

5. C0NT:
1. Serum Creatinine: This blood test measures the level
of creatinine, a waste product from muscle metabolism
that is normally filtered by the kidneys. Elevated
creatinine levels can indicate reduced kidney function.
2. Blood Urea Nitrogen (BUN): BUN measures the
amount of nitrogen in the blood that comes from urea,
a waste product of protein breakdown. Elevated BUN
levels can suggest impaired kidney function or other
factors affecting nitrogen metabolism.
3. Estimated Glomerular Filtration Rate (eGFR):
eGFR is calculated based on serum creatinine levels
and factors like age, sex, and race. It provides an
estimate of how well the kidneys are filtering waste
from the blood.

6. UROLITHIASIS:
Urolithiasis (from greek ouron-urine and lithos-stone) is the condition where
urinary stones are formed or located anywhere in the urinary system.
Types of stones:
1. Kidney stones
2. Ureteral stones
3. Bladder stone
4. Urethral stone

7. RISK FACTORS:
 Age (younger age group, peak at 40)
 Sex (male) • Strong family history of stone formation
 Positive family history
 Diet: obesity
 High animal protein (high ca, uric & oxalate, low pH, low citrate)
 High salt (hypercalciuria)
 High Calcium intake is protective
 Vit D (increase instestinal Ca absorption)
 Vit C (cause hyperoxaluria)
 Gout
 Low fluid intake

8. DIAGNOSIS:
• Imaging Tests: X-rays, ultrasound, and CT scans can help visualize the size
and location of kidney stones.
• Urinalysis: This can help identify signs of infection, blood, and crystals in the
urine.
• Blood Tests: Blood tests can reveal abnormal levels of substances such as
calcium, uric acid, and creatinine.
• 24-Hour Urine Collection: This test helps measure levels of minerals in the
urine over a 24-hour period.
• Stone Analysis: If you pass a stone, it can be analyzed to determine its
composition, which can help guide treatment and prevention strategies.
• Intravenous Pyelogram (IVP): A dye is injected into a vein, and X-rays are
taken as the dye passes through the kidneys and bladder, highlighting the
urinary tract.

9. SYMPTOMS:
Severe pain in the back, side, or abdomen.
Pain that fluctuates in intensity and radiates to the groin or lower abdomen.
Hematuria (blood in the urine), which may cause urine to appear pink, red, or brown.
Frequent urge to urinate.
Painful urination.
Cloudy or foul-smelling urine.
Nausea and vomiting.
Restlessness

10. COMPLICATIONS:
• Renal Colic
• Obstruction
• Hematuria
• Kidney damage
• Infection
• Hydronephrosis

11. PREVENTION AND TREATMENT:
Stay Hydrated: Drink plenty of water throughout the day to maintain adequate urine
volume and dilution.
Dietary Changes: Reduce sodium intake and limit foods high in oxalate (spinach,
rhubarb, nuts), purines (organ meats, seafood), and sugar-sweetened beverages.
Calcium Intake: Consume an appropriate amount of dietary calcium, either through
food or supplements, as excessive calcium restriction can lead to stone formation.
Moderate Protein: Avoid excessive consumption of animal protein, which can increase
uric acid and calcium levels in the urine.
Limit Caffeine and Alcohol: Excess caffeine and alcohol can lead to dehydration,
which increases the risk of stone formation.
Maintain a Healthy Weight: Obesity is linked to higher stone risk, so maintaining a
healthy weight through balanced diet and regular exercise can help prevent stones.
Medication: Depending on the type of stone, your doctor might prescribe medications
to adjust urine composition and reduce the risk of stone formation.
Citrate-rich Foods: Consuming foods high in citrate (lemons, oranges, certain
vegetables) can help prevent stone formation by inhibiting crystal growth.
Limit Vitamin C Supplements

12. HYPOURICEMIA
(Introduction, risk factors, diagnosis, symptoms and treatment)

13. INTRODUCTION:
Hypouricemia is a medical condition characterized by abnormally low levels
of uric acid in the blood.
Uric acid is a waste product that forms when the body breaks down purines,
which are substances found in certain foods and cells.
 The normal range of uric acid in the blood is typically between 2.4 - 6.0
mg/dL for women and 3.4 - 7.0 mg/dL for men.

14. RISK FACTORS:
 Genetic Factors: Inherited genetic mutations that affect uric acid transport
or metabolism can lead to primary hypouricemia.
 Medications: Taking medications such as allopurinol, probenecid, or high-
dose aspirin can lower uric acid levels and contribute to hypouricemia.
 Kidney Disorders: Conditions like chronic kidney disease or Fanconi
syndrome can result in reduced uric acid reabsorption by the kidneys, leading
to hypouricemia
 Alcohol Consumption: Excessive alcohol consumption can affect uric acid
metabolism and potentially contribute to hypouricemia.
 Pregnancy: Pregnancy can lead to temporary hypouricemia due to changes
in kidney function and increased uric acid excretion.
 Dehydration
 Family History:

15. DIAGNOSIS
Medical history
Physical examination
Blood tests
Urine tests
Genetic testing
Imaging stadies

16. SYMPTOMS:
• Fatigue
• Muscle weakness
• Nausea
• Vomiting
• Joint pain or discomfort (uncommon)
• Kidney stones (rare)
• Neuropathy (nerve damage) (rare)
• Increased susceptibility to infections

17. COMPLICATIONS
Low uric acid levels may lead to the
formation of calcium oxalate stones, a type of
kidney stone. Kidney Infection as the Uric acid is
thought to play a role in immune function, and low
levels might impair the immune response.
Extremely low uric acid levels might be
associated with decreased bone mineral density and
an increased risk of osteoporosis.

18. TREATMENT:
Monitor and observations
Address underlying causes
Medication adjustment
Dietary changes
Genetic counselling
Supplemental therapy