Download Renal Disease

CLS 426 Urine & Body
Fluid Analysis
Renal Disease – Part III
Interstitial & Vascular Disease
Ricki Otten MT(ASCP)SC
uotten@unmc.edu
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
2
Lower UTI
• ~85% of lower UTI caused by
gram-negative rods (fecal E.coli)
• Urinalysis
– Physical
Color? Clear?
– Chemical
– Microscopic
3
Lower UTI
• Urinalysis
– Physical
yellow, hazy (cloudy, turbid)
– Chemical ?
– Microscopic
4
Lower UTI
• Urinalysis
– Physical
– Chemical
yellow, hazy (cloudy, turbid)
+ protein (<0.5 grams/24 hr)
+ leukocyte esterase
+ nitrite
+ blood
– Microscopic ?
5
Lower UTI
– Microscopic
WBC
Bacteria
RBC
Transitional epithelial cells (cystitis)
Absence of casts: why?
6
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
7
Acute Pyelonephritis
• Urinalysis
– Physical
Color? Clear?
– Chemical
– Microscopic
8
Acute Pyelonephritis
• Urinalysis
– Physical
Yellow, hazy (cloudy, turbid)
– Chemical ?
– Microscopic
9
Acute Pyelonephritis
• Urinalysis
– Physical
– Chemical
Yellow, hazy (cloudy, turbid)
+ protein (<1.0 gram/24 hr)
+ leukocyte esterase (WBC)
+ nitrite
+ blood
specific gravity: normal to low
– Microscopic ?
10
Acute Pyelonephritis
– Microscopic
WBC (may see clumping)
Bacteria
RBC
RTE
Casts: WBC, granular, RTE, waxy
11
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)
12
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
13
Yeast Infection
• Urinalysis
– Physical
Color? Clear?
– Chemical
– Microscopic
14
Yeast Infection
• Urinalysis
– Physical
Yellow, hazy (cloudy)
– Chemical ?
– Microscopic
15
Yeast Infection
• Urinalysis
– Physical
– Chemical
Yellow, hazy (cloudy)
+ WBC ?
+ blood ?
– Microscopic
Yeast
Mycelial elements
RBC? WBC?
Casts? Why or why not?
16
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
17
18