1. INVESTIGATIONS OF URINARY SYSTEM
DR. S Chakradhar

2. Normal level 2.5-6.6 mmol/l (15-40mg/dl)
In Blood
Serum Urea:
Normal level mmol/l (15-40mg/dl)
High level can occur in high protein diet, GI bleeding, trauma, hypovolemia, burn.
Low level can occur in low intake, liver failure, over hydration.
Serum Creatinine:
Normal level mmol/l ( mg/dl)
High level can occur in large muscle mass, rhabdomyolysis, drugs like trimethoprim, cimetidine
Low level can occur in small muscle mass.
Serum potassium: (Serum sodium)
Normal level mmol/l
False high levels can occur in hemolysed sample
DR. S Chakradhar

3. Microscopic examination
Urine examination
Broadly divided into
Routine
Special
Physical Examination
Chemical examination
Microscopic examination
DR. S Chakradhar

4. Physical examinations includes Amount (Volume) – 800 – 2500 ml / day
Odour - Pungent
Color of the urine – Straw colour
Appearance – Clear & transparent
Specific gravity – – 1.030
DR. S Chakradhar

5. Chemical examinations includes Reaction – Acidic (avg 6)
Protein (24hrs urine) – less than 150mg/24 hour
Glucose (reducing substance)
ketones
DR. S Chakradhar

6. Microscopic examinations includes Cells
Epithelial cells – normally found in samall number
WBC ( Pus cells )
RBC ( normal, dysmorphic )
Others
Casts --RBC casts, WBC casts, epithelial casts, granular casts
Crystals - uric acid, calcium oxalate, triple phosphate, calcium carbonate etc
DR. S Chakradhar

7. DR. S Chakradhar

8. Calculation of creatinine clearance Cockcroft and Gault:
Estimation of GFR
Calculation of creatinine clearance
Cockcroft and Gault:
{(140-age) X body weight X 1.22 (male) and 1.04 (female)} Divided by serum creatinine in μmol/l
More accurate method:
{Urine creatinine×urine volume} X divided by serum creatinine
Normal range:
Men ml/min
Women ml/min.
DR. S Chakradhar

9. Imaging
Plain X-Ray abdomen
DR. S Chakradhar

10. Excretion urography(IVP/IVU) Antegrade Retrograde
DR. S Chakradhar

11. Excretion urography(IVP/IVU) Antegrade Retrograde
DR. S Chakradhar

12. Micturating cystourography
DR. S Chakradhar

13. Ultrasound
DR. S Chakradhar

14. Renal angiogram
DR. S Chakradhar

15. Computed tomogram (CT)
DR. S Chakradhar

16. T1-weighted axial image without & with contrast medium
Magnetic resonance imaging (MRI)
DR. S Chakradhar
T1-weighted axial image without & with contrast medium

17. Radionuclide studies (DMSA and DTPA)
DR. S Chakradhar

18. Renal biopsy
DR. S Chakradhar