Evaluation of Urine Examination Findings in the Known Patients with Kidney Disease.

Abstract

Kidney diseases have become a major cause of the increased death rate in developing countries.

In the diagnosis and management of kidney disease, the nephrologist should require a number of specific and non-specific investigations, such as blood tests, electric glomerular filtration rate, serum creatinine, blood urea nitrogen test, cystatin C test, kidney biopsy, kidney ultrasound, and urine examination, which help to identify the pathogenic or functional abnormality of the kidney. We know that all the diagnostic tests are useful to diagnose and manage kidney disease, but we also know that many of them come at a very expensive price, which a poor patient would think twice about before spending. In such a situation, along with the inexpensive tests, urine testing proves to be a valuable test for such patients. Urine examination is an important diagnostic tool to evaluate kidney disease. This examination consists of: 1. physical examination, which deals with the examination of color, appearance, volume, pH, and specific gravity. 2. Chemical examination of urine includes examination of protein, sugar, ketone bodies, bile salt, bile pigment, urea, and blood. 3. Microscopic examination consists of the determination of cells such as WBC's, RBC's, epithelial cells, and cast, crystals, bacteria, and miscellaneous substances.

Methods:

We collected 300 known kidney patient urine samples at GSVM Medical College Kanpur and the School of Health Sciences, CSJM University Kanpur, and performed them in the laboratory manually. We prepared a urine smear using urine sediment obtained by centrifugation of urine and examined the smear microscopically as well as grossly (physical examination) and chemically.

Results:

When we did a urinalysis of 300 known kidney patients, we found that 70% of the patients had proteinuria, of which 40% were male and 30% were female; about 10% of these patients had proteinuria with glycosuria. In microscopic examination observations, 70% of patients have hematuria, 94% have 1–10 epithelial cells/hpf, and 6% have 10–25 epithelial cells/hpf. And 54% of patients have an abnormal Pus cell count. We also observed some crystals like Uric acid, amorphous urate, calcium oxalate, and triple phosphate in 28% of the patient samples.

Conclusion:

Urine testing has shown the potential to be a good diagnostic tool for kidney patients, which helps urologists in treating kidney patients and also help in investigating the current condition of the patients. Testing for protein in urine has proved to be a good test to check the pathological condition of the kidney. Proteinuria with glycosuria gives an indication of the association of kidney disease with diabetes.