The first approach to the study of renal function is the standard urine examination, improperly called “complete urine examination.” According to Angelo Burlina, the standard urine test is a set of qualitative data that is easy to obtain and of safe clinical interpretation. Indeed, it is an organ’s metabolic profile that can provide some fundamental information both on the morpho-functional status of the kidneys and on the status of many metabolic pathways, including those involved in the hydroelectrolytic balance and in the metabolism of carbohydrates and proteins. Although the standard urine test is simple to perform and easy to interpret, it is necessary to properly manage the pre-analytical phase to avoid misleading results resulting from improper sample collection or from unsuitable transport and storage conditions. The standard urine examination allows detecting the presence of clinically relevant indices both in chemical–physical examination (hemoglobin, proteins, glucose, etc.) and in microscopic examination of the sediments (blood cells, parenchymal cells, microorganisms, etc.). In recent years, the application of cytofluorimetric techniques to the analysis of urinary sediments and the introduction of new automated techniques, such as optical flow microscopy with digitization and image analysis through neural networks, have allowed a reevaluation of urinary microscopic analysis, with undoubted advantages for the nephrologist, who has always assigned great clinical importance to this examination. The chemical physical examination is carried out in all clinical laboratories by complete automation allowing semiquantitative results to be obtained from the photometric reading of dipsticks. Thanks to their wide diffusion and the simplicity of their use, the physical–chemical examination is also carried out by the patients themselves or by their families at home, especially in the monitoring of the therapy of chronic nephropathies such as nephrotic syndrome. However, physical–chemical examination has some limitations that must be considered when evaluating the results. For example, the presence of chromogenic catabolites in the urine or the presence of drugs may interfere with color formation in some dipstick reactions, such as the assessment of proteinuria, which represents one of the most clinically relevant data. The principle of a proteinuria dipstick is based on the protein error of pH indicators: the color of certain indicators at a given pH changes if they bind to proteins in the urine sample. In other words, it is a paper soaked in tetrabromophenol, a pH indicator, which changes its color when binding to proteins present in the sample. The presence of proteinuria evidenced by the standard urine test must be confirmed by quantitative and qualitative examinations, which allow assessing the concentration and composition of proteinuria. Even the absence of proteinuria on physical–chemical examination must be confirmed by further tests if there is a definite diagnostic suspicion (e.g., amyloidosis, multiple myeloma, etc.). Indeed, it is known that a dipstick is unable to detect the presence of Bence Jones proteinuria, even if present in significant amount and, therefore, the interpretation of the results must always take into account the clinical question underlying the request for standard urine test. Even hematuria, which can be detected both by physical–chemical and microscopic examination of the sediments, has a great clinical value, especially in cases of microhematuria, when no alteration is detectable by observation of the sample with the naked eye (e.g., the color). Once identified, hematuria must be clinically investigated to establish both the site of its origin (it can originate from any part of the urinary system) and the etiology. In CKD, some abnormalities of the urine sediments are indicative of parenchymal damage: microscopic hematuria with anisocytosis in glomerular basement membrane alterations, erythrocyte cylinders in proliferative glomerulonephritis, leukocyte cylinders in pyelonephritis and interstitial nephritis, hyaline cylinders with fat globule inclusions in renal diseases characterized by proteinuria, and granular cylinders with tubular epithelial cells in many conditions of renal parenchymal impairment. The National Institute for Health and Care Excellence (NICE) guideline on AKI recommends that urine chemistry and physical examination (dipstick) for blood, proteins, leukocytes, nitrites, and glucose should be performed as soon as possible in all patients with suspected or confirmed AKI.

اخر الاخبار

اخبار العتبة العباسية المقدسة

قسم الشبابيك: تقديم أكثر من 50 ألف وجبة طعام لزائري الأربعين

قسم الشؤون الخدمية يطلق حملة تنظيف لمنطقة باب بغداد بعد انتهاء زيارة الأربعين

قسم الشؤون الفكرية: نحو 5000 مستفيد من خدمات محطة مجمّع سيد الماء الثقافي

مجمع أبي الفضل العباس (عليه السلام): أكثر من 30 ألف مستفيدة من الخدمات الصحية في زيارة الأربعين

المزيد

الآخبار الصحية

"ساعة الذئب" تؤرق الملايين.. حل علمي ينقذ نومك

يخفف الألم.. معجون أسنان مصنوع من الشعر ؟!

كوابيسك ليست عشوائية.. ماذا تحاول أن تخبرك؟

5 مخاطر غير متوقعة لتناول البروتين بكثرة

المزيد

الآخبار التكنلوجية

أندرويد 16 على الأبواب..هاتفك سيصبح وكيلك الذكي !

"غوغل" مهددة ببيع متصفحها الشهير "كروم".. من المشتري؟

"ناسا" و"غوغل" تطوران مساعدا طبيا ذكيا لمرافقة رواد الفضاء

هل تشغيل تكييف السيارة على "الحد الأقصى" ضار؟

المزيد

مواضيع ذات صلة

Estimation of the Glomerular Filtration Rate by Equations

Creatinine test for Diagnosis of Kidney Diseases

Urea test for Diagnosis of Kidney Diseases

Diagnosis of Ventilator-Associated Pneumonia

protein C, protein S

prostate-specific antigen (PSA), prostate cancer gene 3 (PCA3), MI-prostate score (MiPS)

prolactin levels (PRLs)

Enzyme-Linked Immunosorbent Assay (ELISA)

Agglutination Reaction

Precipitation Reaction

Heparins and Fondaparinux

Activated Partial Thromboplastin Time (aPTT)