CBC, 

ESR, 

PBF

Epo deficiency

marrow suppression from retained toxin

• Repeat test if positive

• normal- sufficient to rule out proteinuria
• if elevated → quantification with 24 hour UTP

• specially for screening and monitoring of DM patients
• if positive, repeat the test
• established microalbuminuria if 2 out of 3 tests are positive
• Microalbuminuria: 2.5 -30 / 3.5-30 mg/mmol

Urine analysis with Phase contrast microscopy – fresh sample for

Physical:

• color, odor, turbidity, PH, Sp. gravity 

Chemical

• glucose, protein

microscopy

• bacteria
• cell, cast, crystal

• Crystal
  • calcium oxalate→ ethylene glycol ingestion
  • renal stone 
• WBC: indicates inflammation
  • UTI, pyelonephritis, chemical injury, autoimmune
  • GN, AIN, CIN,
  • appendicitis, diverticulitis 
• WBC cast: indicates renal origin of WBC

• Pyelonephritis, GN, AIN, CIN

• • RBC:
    • Glomerular > 20% dysmorphic 
  • RBC cast: renal origin of hematuria
    • GN, SCD, IE, vasculitis, malignant hypertension
• Hyaline cast
• Physiological, renal disease

• Tubular (epithelial) cast:
  • tubular injury → ATN
  • heavy metal poisoning, ethylene glycol, eclampsia
• Granular cast:
  • Glomerular disease
  • Tubulointerstitial: ATN
• Fatty cast:
  • Nephrotic syndrome 
• Broad cast: 
  • AKA “renal failure cast”

High serum urea 

• reduced GFR, renal perfusion, urine flow rate
• high protein intake, 
• gastrointestinal hemorrhage 
• catabolic states. 

Low serum urea: 

• chronic liver disease 
• anorexia or malnourished.

High serum creatinine

• reduced GFR, 
• high muscle mass
• drugs

Elevated urea:creatinine ratio

• indicative of volume depletion and pre-renal failure

1. Calcium low, Phosphate high, vit D low, PTH high
2. high ALP

1. CKD
2. indicative of renal osteodystrophy

• Serum bicarbonate low

• renal failure, RTA

• Serum albumin

• malnutrition/malabsorption, liver disease
• negative acute phase response 
• nephrotic syndrome → urinalysis

Underlying disease

1. Glucose, HbA1c
2. CRP

1. DM
2. sepsis, vasculitis 

• ANA, Anti ds DNA, ENA

• renal disease secondary to SLE

• ANCA 

• GN secondary to systemic vasculitis

• Complement level

• low in some kidney disease

• Anti-GBM ab

• Goodpasture’s disease

• Anti-phospholipase A2 receptor (anti-PLA2R)

• primary membranous nephropathy.