1. Renal Function Tests Prof. K. Sivapalan.

2. Specific Gravity Normal- 1.010 to 1.025 Indicates the degree of concentration. May be high when heavy molecular weight substances as some dyes are excreted. Less in compulsive drinking, chronic nephritis, diabetes insipidus. 03-12-07

3. Volume 24 hour volume- normal 1500 ml or 1 ml/min. If close to 500 ml, specific gravity should be increased. If less than 400 ml, GFR is reduced. Water restriction test- indicates concentrating power, differentiate compulsive drinking from diabetes insipidus. Water diuresis- drinking of large volume of hypotonic fluid [water]- diuresis starts in 15 minutes, maximal in 40 minutes.- ADH. 03-12-07

4. Proteinurea. Albumin can be present in diseases of glomerulus. Plasma proteins can be present on bleeding into nephrons, ureter, bladder, urethra. Some abnormal proteins can be filtered when produced. 03-12-07

5. Haemoglobin Urea Haemoglobin can be filtered normally. Presence indicates intravascular haemolysis. Risk of haemoglobin crystalizing in tubules when concentration increases and blocking tubules. 03-12-07

6. Microscopic Examination Red cells- inflammation or bleeding. In females- menstruation. White cells- few cells- normal. Increased means infection. Micro organisms- normal urethral commensasl or infection- [mid stream] Crystals, epithelial cells, casts- pathology 03-12-07

7. Titratable Acid, pH. Normal pH- 4.5 to 6. It is concentration and depends on urine flow also. Titratable acid does not account for acid combined with bicarbonate. 03-12-07

8. Clearence. Clearence = UV/P It is an estimation of the volume of plasma cleared of a perticular substance in one minute. PAH- plasma flow Inulin, creatinine, urea – GFR. Because urea is diffusible in and out of tubules the value varies depending on the flow. Free water clearance- –C H 2 O = V - U osm V/ P osm. 03-12-07

9. Blood Parameters Blood urea- increase means reduced renal function Electerolytes Bicarbonate and PCO 2 Protein 03-12-07

10. Imaging X’ray- stones Ultrasound- change in size, shape Intravenous pyelogram- internal structure- pelvis, ureters, bladder, urethra. 03-12-07