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pH
- Normal = 4.5 - 8.0
- Increased = Alkalosis
- Decreased = Acidosis, Intrarenal ARF
- Should be on acidotic side to discourage bacterial overgrowth
-
Specific Gravity
- Normal = 1.003 - 1.030
- Increased = volume deficit, glycosuria, proteinuria, prerenal ARF (>1.020)
- Decreased = volume overload
- Measure of the concentration of urine
- (Closer to 1 = more dilute)
-
Osmolality
- Normal = 300 - 1200 mOsm/kg
- Increased = volume deficit, prerenal ARF (urine osmol > serum osmol)
- Decreased = volume excess, intrarenal ARF (urine osmol < serum osmol)
-
Protein
- Normal = 30 - 150 mg/day
- Increased = trauma, infection, intrarenal ARF; transient with exercise; glomerulonephritis
- *Does not belong in urine. If seen, think problem with glomerulus
-
Sodium
- Normal = 27 - 287 mEq/day
- Increased = High sodium diet; intrarenal ARF
- Decreased = prerenal ARF
- Help differentiate between injury and failure
-
Creatinine
- Normal = 1 - 2 g/day
- Decreased = intrarenal ARF, CRF
- Less creatinine in urine is problem in tubular system
-
Urea
- Normal = 6 - 17 g/day
- Decreased = intrarenal ARF, CRF
-
Myoglobin
- Normal = absent
- Increased = crush injury, rhabdomyolysis
- From muscle cells; nephrotoxic and giant clogging tubules; seen with trauma
-
RBCs
- Normal = 0 - 5
- Increased = trauma, intrarenal ARF, strenuous exercise, renal artery thrombus
-
WBCs
- Normal = 0 - 5
- Increased = infection
- Look for leukocyte esterase - more sensitive than WBCs
-
Bacteria
- Normal = none - few
- Increased = infection
-
Casts
- Normal = none - few
- RBC = glomerular disease
- WBC = pyelonephritis, glomerular disease, nephrotic syndrome
- Epithelial = glomerular disease
- Broad waxy casts = longstanding kidney dysfunction (very negative)
- Sediment tells you site of pathology
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