Renal Biochemistry

  • Renal failure important to know to determine need for haemodialysis
    • rate of rise of urea
    • if K+ rising

Chemistry Tests

serum

 
  • Need urea and creatinine
    • in dehydration urea rises much faster
    • catabolism leads to high urea (e.g. 8 mmol/l, creatinine normal)
    • need to lose about 2/3 kidney function before creatinine rises

 
urine

 
  • microalbuminuria (small amount of normal albumin in urine)
    • gradually increases from
      1.  intermittent microalbuminuria,
      2. persistent microalbuminuria,
      3. frank proteinuria
      4. renal failure
  • mark of vascular damage so do blood pressure and fundoscopy
  • treat with v. tight BP control
    • ACE inhibitors
    • Angiotensin II receptor inhibitors
creatinine clearance

 

Other Tests

  • Blood pressure
  • Microscopy of urine
  • Ultrasound scan of kidney

Disorders

 

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