1. Ricki Otten MT(ASCP)SC uotten@unmc.edu
CLS 426 Urine & Body Fluid Analysis Renal Disease – Part III Interstitial & Vascular Disease
Ricki Otten MT(ASCP)SC
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

2. Interstitial Tissue Disease
Lower urinary tract infection
Cystitis (bladder)
Urethritis (urethra)
Acute pyelonephritis (upper UTI)
Yeast infection
Any bacterial or fungal agent can cause a UTI
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

3. Lower UTI ~85% of lower UTI caused by
gram-negative rods (fecal E.coli)
Urinalysis
Physical Color? Clear?
Chemical
Microscopic
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

4. Lower UTI Urinalysis Physical yellow, hazy (cloudy, turbid) Chemical ?
Microscopic
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

5. Lower UTI Urinalysis Physical yellow, hazy (cloudy, turbid)
Chemical + protein (<0.5 grams/24 hr)
+ leukocyte esterase
+ nitrite
+ blood
Microscopic ?
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

6. Lower UTI Microscopic WBC Bacteria RBC
Transitional epithelial cells (cystitis)
Absence of casts: why?
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

7. Acute Pyelonephritis Most common upper UTI
Two mechanisms causing infection
Bacterial moving from lower to upper urinary tract
Septicemia localizing in the kidneys
Incomplete voiding due to obstruction or dysfunction or anatomic abnormality
Catheterization, pregnancy, diabetes
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

8. Acute Pyelonephritis Urinalysis Physical Color? Clear? Chemical
Microscopic
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

9. Acute Pyelonephritis Urinalysis Physical Yellow, hazy (cloudy, turbid)
Chemical ?
Microscopic
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

10. Acute Pyelonephritis Urinalysis Physical Yellow, hazy (cloudy, turbid)
Chemical + protein (<1.0 gram/24 hr)
+ leukocyte esterase (WBC)
+ nitrite
+ blood
specific gravity: normal to low
Microscopic ?
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

11. Acute Pyelonephritis Microscopic WBC (may see clumping) Bacteria RBC
RTE
Casts: WBC, granular, RTE, waxy
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

12. Yeast Infection
Urinary tract of both men and women are susceptible to yeast infection
Most often vaginal yeast infection contaminates urine
Often caused by Candida species
(candida albicans)
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

13. Yeast Infection Candida species (candida albicans)
Normal flora of GI tract and vagina
Normal bacterial flora keep yeast proliferation under control
Catheters provide mode of inoculation
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

14. Yeast Infection Urinalysis Physical Color? Clear? Chemical Microscopic
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

15. Yeast Infection Urinalysis Physical Yellow, hazy (cloudy) Chemical ?
Microscopic
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

16. Yeast Infection Urinalysis Physical Yellow, hazy (cloudy)
Chemical + WBC ?
+ blood ?
Microscopic
Yeast
Mycelial elements
RBC? WBC?
Casts? Why or why not?
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

17. Vascular Disease
Any disorder that affects the blood flow to the kidneys can cause renal disease
Cardiac disease (25% of cardiac output)
Atherosclerosis
Hypertension
Diabetes
Eclampsia
Etc
CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease

18. CLS 426 Urine & Body Fluid Analysis Student Lab Rotation: Renal Disease