acute renal failure diagnostic test

The acute kidney failure diagnostic test is an auxiliary test method for determining whether the kidney is normal. On the basis of the causes of surgery, trauma, shock, hemorrhage, etc., oliguria and anuria are the clues for the diagnosis of acute renal failure. If the urine volume is less than 17 ml per hour or the amount of urine is less than 400 ml within 24 hours; or the hypotension is treated with anti-shock, the blood volume is up to 3 hours, and the urine volume is still below 17 ml per hour, even within 24 hours. If the urine volume is less than 100 ml, it can be considered that acute renal failure has occurred, and should be further examined immediately for identification and definitive diagnosis. Basic Information Specialist classification: urinary examination classification: urine / kidney function test Applicable gender: whether men and women apply fasting: not fasting Tips: Maintain regular routines and diet to help the inspection go smoothly. Normal value 1. No signs of hypovolemia, normal or high blood pressure. 2. 24-hour urine volume is less than 400 ml, or 1 hour urine volume is less than 17 ml. 3. The specific gravity of urine is fixed at 1.010 or so, generally not higher than 1.010. 4. Urine protein is positive, urine test has red blood cells, coarse granular casts, a large number of renal tubular epithelial cells, necrotic epithelial cell casts, and some appear hemoglobinuria and pigmented casts. 5. The urinary sodium content often exceeds 40 meq/liter, at least not less than 30 meq/liter. 6. Blood potassium and non-protein nitrogen rise faster and more obviously. 7. The mannitol test did not respond. Clinical significance Abnormal results: First, the urine test urine, urine volume ≤ 17ml / h or <400ml / d, urine specific gravity is low, <1.014 or even fixed at 1.010 or so, urine is acidic, urine protein qualitative + ~ + + +. 2. Nitrogenemia Blood urea nitrogen and creatinine increase: Urea nitrogen can also be elevated in patients with severe gastrointestinal bleeding due to normal renal function. Increased serum creatinine, blood urea nitrogen / serum creatinine ≤ 10 is an important diagnostic indicator. In addition, urine / blood urea <15 (normal urine urea 200-600mmol / 24h, urine / blood urea > 20), urine / serum creatinine ≤ 10 also has diagnostic significance. Third, blood tests for red blood cells and hemoglobin decreased, white blood cells increased, thrombocytopenia. Fourth, urine sodium quantitative> 30mmol / L filtered sodium excretion fraction (FENa) determination, FENa = its value > 1 for acute tubular necrosis, non-oliguric acute tubular necrosis and urinary tract obstruction. Those with a value <1 are pre-renal azotemia and acute glomerulonephritis. 5. Determination of pure water clearance rate, this method is helpful for early diagnosis. Pure water clearance = urine volume (1 hour) (1-urine osmotic pressure / blood osmotic pressure), its normal value is -30, the greater the negative value, the kidney function is super good; the closer to 0, the more severe the renal function. -25 to -30 indicates that renal function has begun to change. -25～-15 indicates mild and moderate damage to renal function. -15 to 0 indicate severe damage to kidney function. People who need to be examined: suspected to be acute renal failure patients. Precautions 1. Note: Inappropriate people: Generally, there is no suitable for the crowd. Taboo before the examination: Maintain regular routines and diet to help the inspection proceed smoothly. Requirements for inspection: 1. The specific methods of this test are slightly different from each scholar's report, but do not affect the test results. 2. Strict aseptic operation should be performed when indwelling the catheter. The doctor asked the patient to dispel their ideological concerns and cooperate with the trial. According to the doctor's instructions, the patient actively cooperated with the doctor for examination, and the doctor carefully examined and carefully observed the results. Inspection process First, urine examination: less urine, urine volume ≤ 17ml / h or <400ml / d, urine specific gravity is low, <1.014 or even fixed at 1.010 or so, urine is acidic, urine protein qualitative + ~ + + +, urine sediment microscopic examination Large coarse tube type, a few red and white blood cells can be seen. Second, azotemia: blood urea nitrogen and creatinine increased. However, azotemia cannot be used as a basis for diagnosis alone, and urea nitrogen may also be elevated in patients with severe gastrointestinal bleeding when renal function is normal. Increased serum creatinine, blood urea nitrogen / serum creatinine ≤ 10 is an important diagnostic indicator. In addition, urine / blood urea <15 (normal urine urea 200-600mmol / 24h, urine / blood urea > 20), urine / serum creatinine ≤ 10 also has diagnostic significance. Third, blood tests for red blood cells and hemoglobin decreased, white blood cells increased, thrombocytopenia. The blood potassium, magnesium, and phosphorus are increased, the blood sodium is normal or slightly decreased, the blood calcium is lowered, and the carbon dioxide binding force is also lowered. Fourth, urinary sodium quantitative> 30mmol / L. filtered sodium excretion fraction (FENa) determination, the method has a certain significance for the cause. FENa=value >1 for acute tubular necrosis, non-oliguric acute tubular necrosis and urinary tract obstruction. Those with a value <1 are pre-renal azotemia and acute glomerulonephritis. 5. Determination of pure water clearance rate, this method is helpful for early diagnosis. Pure water clearance = urine volume (1 hour) (1-urine osmotic pressure / blood osmotic pressure), its normal value is -30, the greater the negative value, the kidney function is super good; the closer to 0, the more severe the renal function. -25 to -30 indicates that renal function has begun to change. -25～-15 indicates mild and moderate damage to renal function. -15 to 0 indicate severe damage to kidney function. Not suitable for the crowd There are no special taboos. Adverse reactions and risks No related complications or hazards.