Most patients with chronic kidney disease have no symptoms or mild symptoms in the early stage, so early laboratory tests are very important. To achieve early detection, the key is to insist on regular screening every year. Even if there are no symptoms, it is usually necessary to screen urine routine and kidney function once a year. If you already have high blood pressure, diabetes, etc., you should have regular urine routine and kidney function tests twice or more per year (depending on your condition). If you already have certain symptoms, you should go to the hospital for a more comprehensive examination as soon as possible.
1, urinary routine: urinary routine is the easiest examination of the urinary system for the presence of lesions, the nature and extent of lesions. Among them.
(1) urine protein (Pro): positive urine protein is often caused by kidney disease, but excessive plasma protein, strenuous exercise, fever, heart failure, pericardial effusion and drugs may also cause positive urine protein.
(2) Glucose (Glu): positive urine glucose indicates decreased renal tubular reabsorption or diabetes mellitus. When blood glucose is normal and urine glucose is positive, it is called “renal diabetes”, which means that the renal tubular reabsorption of glucose is abnormal (glucose leaks out from the renal tubules), not diabetes.
(3) Red blood cells (Ery): positive urine red blood cells is called “hematuria”. In light cases, hematuria cannot be detected by the naked eye and can only be determined by microscopic examination, called “microscopic hematuria”; in heavy cases, the urine is the color of washed water or even blood, called “carnal hematuria”. “Hematuria is commonly seen in glomerulonephritis, urinary tract infection, urinary stones, and sometimes in tumors, cysts, malformations, and trauma of the urinary tract.
(4) Leukocytes (LEU): Fresh middle urine examination, if leukocytes (1+~4+) are present, it often indicates urinary tract infection, and sometimes it can also indicate non-infectious interstitial renal tubular lesions.
(5) Other influencing factors: drugs or food can change the color and pH of urine; dilution of urine after drinking a lot of water can affect urine specific gravity and other items; urine test during menstruation and within 2-3 days before and after menstruation in female patients can affect urine results.
2.Urine red blood cell morphology examination: if urine anomalous red blood cells >80% are found, hematuria should be considered to come from the glomerulus.
3.Serum creatinine concentration (sCr).
4.Myohepatic clearance (Ccr).
5.24-hour urine protein quantification: normal value <0.2 g/24 hours. If the 24-hour urine protein quantification increases, it can reflect the degree of glomerular or tubular lesions. This test is more accurate than the urine routine urine protein test, and thus can better reflect the condition. However, urine retention of less than 24 hours, mixed with foreign substances in the urine, the same day eat a lot of protein will affect the test results.
6, urine microalbumin quantification: is to check the urinary microalbumin excretion rate. The normal value is <20mg/min or <30mg/24h. If the result is 20-200mg/min or 30-300mg/24h, then it can be determined as microalbuminuria. This test can sensitively measure microalbumin in urine and is one of the sensitive indicators to determine early kidney damage. For patients with hypertension, diabetes, recurrent long-term urinary tract infections, drug intoxication, etc., urine microalbumin should be tested regularly to detect disease damage as early as possible.
7, urinary low molecular protein: β2-microglobulin, a1-microglobulin, transferrin, light chain protein and other urinary low molecular weight proteins are a group of proteins that can be freely filtered by the glomerulus, but all reabsorbed in the proximal tubule. It is commonly found in various tubulointerstitial nephritis, such as chronic pyelonephritis, hypertensive kidney damage, uric acid nephropathy, renal tubular acidosis, drug-related kidney damage, etc.
8, urine osmolality: normal value 600-1400 (mOsm/kg・H2O). Urine osmolality measurement value is more reliable than urine specific gravity, and its level decreases indicates that the renal tubular concentration function is reduced.
9, clean middle urine bacterial culture and drug sensitivity test: to understand the pathogenic bacteria species of urinary tract infection, to provide the basis for clinical selection of antibiotics.
10.Urine pathological examination: to understand the presence of urinary tumors and the classification of tumor cells.
11.B-type ultrasonography: It can understand the size and shape of kidney, the presence of stones, tumors, cysts, hydronephrosis, urinary tract obstruction, congenital malformation and other lesions.
12.Nephrogram and renal dynamic imaging: to understand the renal blood flow, glomerular filtration function, renal excretion function of each of the left and right kidneys, as well as to indicate the presence of renal artery stenosis.
13.Intravenous pyelogram: to observe the structure and function of the organs of the urinary system and to understand the characteristics and nature of the lesions in the urinary tract.
14.Renal CT and magnetic resonance imaging (MRI): CT and MRI can detect fine calcifications and stones that cannot be detected by ordinary X-rays. It can also determine the location and nature of kidney lesions or congenital developmental abnormalities. It can also assist in the diagnosis of renal tumors, renal tuberculosis, renal cysts, etc. MRI has higher resolution and minimal damage to the body, which are its main advantages.