Kidney medical disease:

1. Renal function:

   • routine urinalysis: this test (U/A) inexpensively screens for all parameters but in only a semi-quantitative way. The sediment exam gives an idea of presence or absence of...and types of...casts. An obsolete (as of about 1965) attempt to quantitate the sediment exam was the Addis count from a bladder specimen accumulated during about 12 hours overnight; and it was serially tested in cases of renal disease as an attempt to discern worsening or betterment of the disease course.
   • National Kidney Disease Education Program glomerular filtration rate (GFR) on-line calculator
   • microalbumin screen ("dipstick") test: very sensitive screen for onset of early albuminuria in suspected diabetics or persons with such as autoimmune disease who are likely to develope renal disease.
   • microalbumin quantitative test thru LMC lab
   • albumin testing for proteinuria in LMC lab
   • hematuria & hemoglobinuria testing
   • Nephron Website
2. Urine testing, other:
   • myoglobin test, urine
3. Percutaneous medical biopsies of kidney: our pathologists work with the radiologist or nephrologist in one of the ultrasound rooms to be sure to obtain adequate biopsies. Most of sample is sent to Charles Jenette, M. D.'s lab at UNC-CH (after our pathologist divides the specimen by low-power microscopic dissection so that glomeruli are preserved for 3 different modes of study [LM, FM, & EM] which takes several weeks). We may keep part of the sample for rapid preliminary glomerular & interstitial diagnosis the next day (will tend to require 3 core biopsies instead of just two): obvious interstitial infiltrate?; glomeruli thrombotic (also look for thrombocytopenia, RBC fragments on blood smear, elevated LDH & elevated bilirubin) from a microangiopathy or TTP/HUS? vs. necrotizing? vs. crescentic? vs. hypercellular? vs. deposits? [LMC-04-3013]. We may need to look at prox. tubular epithelium for signs of injury...such as brush border loss (CD10 stains brush border), epithelial disorder, epithelial drop-out, epithelial "simplification" because that could indicate tubulo-interstitial nephritis or even "adult minimal change glomerulopathy with acute renal failure syndrome" [LMC-04-5045]. Atlas of Kidney Disease

1. types
2. IHC findings:
   • discussion
   • chart of reactions
3. grade
4. stage

• Other Urinary Tract:

(posted 2002; lasted addition 9 May 2007)