Anamnesis
• Anamnesis morbi
-overcooling
-infection (streptococcus, viruses, HIV, syphilis, tuberculosis, leptospirosis, hemorrhagic fever, malaria)
-allergic reactions
- gestosis, miscarriage
-drugs (analgesic, gold containing preparations, D- penicillamin, aminoglycosides, antiepileptic drugs)
-alcohol/ narcotic abuse
Anamnesis
• Anamnesis vitae
-old and concomitant diseases: chronic tonsillatis, AH, DM, gout, liver pathology, tumors, chronic purulent diseases, tuberculosis, systemic diseases (SLE, reumatic arthritis, systemic vasculitis)
-profession: contact with radiation, benzol, solvents, hydrocarbons, heavy and rare metals, poisons
-family history (polycystic disease, Alport syndrome, Fanconi syndrome and other)
Laboratory methods
Urinary test
•Common urinary test
•Nechiporenko test (in 1ml Er<1000, L<2000)
•Zymnitsky test (1005-1025, day diuresis 2/3, night diuresis 1/3)
•Urine culture (bacteriuria >105)
•24 h proteinuria (N <0,05 g)
•microalbuminuria (30-300 mg/24 h)
•Biochemical urinary test
Laboratory methods
Clinical blood test
Immunology
•ASLO, CRP (acute GN)
•Compliment, ANF, LE-cells, immunoglobulines A, M, G (SLE)
•ANCA (Wegener vasculitis)
•Antibodies to glomerular basal membrane (Goodpscher’s syndrome)
•Antibodies to cardiolipins (antiphospholipin syndrome)
•Markers of HBV и HCV, cryoglobulins (hepatitis, cirrhosis)
Proteinuria
•Selective (proteins with low molecular mass - albumin)
•Nonselective (proteins with medium and h[gh molecular mass)
•Glomerular
•Tubular (<2 g/24 h, proteins with low molecular mass –
ß2-microglobulin)
•Overflow or Bence Jones proteinuria (myeloma)
•Functional proteinuria
-orthostatic
-exertional
-feverish
-idiopathic
erythrocytes in 1 ml
Blood in urine may be obvious, associated with a cloudy colour or only apparent on chemical testing (microscopic haematuria). Whether the passage of blood is painful or painless may be diagnostic assistance.
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Haematuria
Painful
kidney stonesurinary tract infectionpapillary necrosis
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Haematuria
Painless
infection
cancer of the urinary tractacute glomerunephritis
contamination during menstruation
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CAUSES OF RED OR DARK URINE
Haematuria
Haemoglobinuria: red urine, stick test for blood positive, but no red cells on microscopy
Myoglobinuria: in rhabdomyolysis. Very dark or black urine. Stick test for blood positive, but no red cells on microscopy
Food: beetroot (anthocyanins)
Drugs: phenophtalein (pink when alkaline), senna and other anthroquinones (orange), rifampicin (orange), L-dopa (darkness)
Porphyria (urine turns dark on standingAlkaptonuria
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